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结核性及恶性肿瘤性胸腔积液淋巴细胞亚群比例以及Th1/Th2免疫平衡研究 被引量:7
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作者 凡瞿明 张国元 +4 位作者 刘剑平 严明生 刘彦华 唐中 何兰 《第三军医大学学报》 CAS CSCD 北大核心 2008年第18期1749-1752,共4页
目的探讨Th1/Th2免疫应答平衡在结核性和恶性肿瘤性胸腔积液病理生理过程中的可能作用。方法对24例治疗前结核性胸腔积液以及28例患者恶性胸腔积液患者胸液标本进行有核细胞计数、分类和流式细胞仪检测淋巴细胞亚群,检测CD3+,CD3+CD4+、... 目的探讨Th1/Th2免疫应答平衡在结核性和恶性肿瘤性胸腔积液病理生理过程中的可能作用。方法对24例治疗前结核性胸腔积液以及28例患者恶性胸腔积液患者胸液标本进行有核细胞计数、分类和流式细胞仪检测淋巴细胞亚群,检测CD3+,CD3+CD4+、CD3+CD8+T淋巴细胞亚群比例,并计算CD4+/CD8+值;利用夹心酶联免疫吸附测定(ELISA)法检测胸液标本中INF-γ、IL-18、TNF-α以及IL-10的浓度。结果结核性胸腔积液患者胸水中T辅助淋巴细胞以CD3+CD4+细胞为主,其CD3+细胞比例、CD3+CD4+细胞比例以及CD4+/CD8+值均高于恶性肿瘤性胸腔积液组(P<0.01)。2组研究对象INF-γ、IL-18、TNF-α以及IL-10的浓度分别是(中位数):结核性胸腔积液组942.0、1 526、62 pg/ml和153 pg/ml;恶性胸腔积液组10.35、1 763、8.85 pg/ml和66.85 pg/ml。结核性胸腔积液中INF-γ、TNF-α以及IL-10均明显高于恶性肿瘤性胸腔积液中的水平(P<0.01),且平均分别高约90倍、7倍和2倍。IL-18在2组胸腔积液中的含量无显著性差异(P>0.05)。结核性胸腔积液IL-18/IL-10明显低于恶性肿瘤性胸腔积液组(P<0.01)。结论结核性胸腔积液表现为Th1免疫应答为主;而恶性肿瘤性胸腔积液患者存在明显的细胞免疫功能低下。这种低下可能主要以T辅助淋巴细胞受损、Thl免疫应答降低以及Th2免疫应答升高为主。IFN-γ可作为鉴别结核性胸腔积液和恶性肿瘤性胸腔积液特异性和敏感度较高的指标。 展开更多
关键词 结核胸腔积液 恶性肿瘤性胸腔积液 1型辅助T淋巴细胞 2型辅助T淋巴细胞 细胞因子
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内科胸腔镜在不明原因胸腔积液诊断中的应用价值 被引量:2
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作者 何啟忠 曾煜 +6 位作者 彭敏 刘旺 郑珍珍 刘土轩 王满霞 吴格怡 成俊芬 《广东医科大学学报》 2021年第2期180-182,共3页
目的了解内科胸腔镜对不明原因胸腔积液患者进行病因诊断的临床应用价值。方法回顾性分析50例不明原因胸腔积液患者的临床及病理资料,包括内科胸腔镜下活检病理结果、不同类型的胸腔积液其镜下的表现特征。结果50例不明原因胸腔积液患... 目的了解内科胸腔镜对不明原因胸腔积液患者进行病因诊断的临床应用价值。方法回顾性分析50例不明原因胸腔积液患者的临床及病理资料,包括内科胸腔镜下活检病理结果、不同类型的胸腔积液其镜下的表现特征。结果50例不明原因胸腔积液患者中通过内科胸腔镜检查后最终确诊48例,诊断率达96.0%;其中恶性肿瘤性胸腔积液13例(26.0%),结核性胸腔积液20例(38.0%),炎症性胸腔积液15例(30.0%),未能确诊2例(4.0%)。内科胸腔镜检查术后并发症中,术后切口疼痛14例,皮下气肿4例,发热2例,无恶性心律失常、大出血、复张性肺水肿等严重并发症。结论内科胸腔镜对不明原因胸腔积液的诊断及良恶性胸腔积液的鉴别具有操作简单、创伤小、安全、诊断率高的特点。 展开更多
关键词 内科胸腔 结核胸腔积液 恶性肿瘤性胸腔积液 诊断
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TEMPORAL TRENDS IN ETIOLOGY AND IN-HOSPITAL OUTCOME IN CHINESE PATIENTS WITH PERICARDIAL EFFUSION:10-YEAR EXPERIENCE OF A SINGLE CENTER
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作者 孙寅光 沈卫峰 +1 位作者 毛原飞 Farouk Mookadam 《Journal of Shanghai Second Medical University(Foreign Language Edition)》 2009年第1期32-38,共7页
Objective To evaluate the evolution of etiology, clinical characteristics, and in-hospital outcomes of pericardial effusions in the recent decade. Methods All patients with a diagnosis of pericardial effusion during h... Objective To evaluate the evolution of etiology, clinical characteristics, and in-hospital outcomes of pericardial effusions in the recent decade. Methods All patients with a diagnosis of pericardial effusion during hospitalization were recruited from the Hospital Inpatient System between January 1996 and December 2005. Demographic and clinical characteristics, laboratory measurements, echocardiographic and treatment features, and in-hospital outcomes were retrospectively reviewed by using a standardized data collection form. Results One hundred and fifry-three consecutive patients were recruited. Mild, moderate and large pericardial effusion occurred in 61 (40%), 52 (34%) and 40 (26%) patients, respectively. The most frequent etiologic diagnoses were tuberculous pericarditis ( n = 50, 33% ) , malignancy ( n = 36, 24% ) and idiopathic pericarditis (n = 35, 23% ). Large effusions were more likely' associated with malignancy (P 〈 0. 01 ). Compared to the initial 5 years (from 1996 to 2000) , the incidence of tuberculous effusion was decreased but neoplastic effusion increased significantly in the recent 5 ),ears (from 2001 to 2005 ). Forty-four patients underwent percardiocentesis (tuberculous in 23, neoplastic in 16, and others in 5) and 28 patients required pericardectomy (tuberculous in 11 and neoplastic in 17). One patient with tuberculous and 3 patients with neoplastic pericardial effusion died during hospitalization. Conclusion Tuberculosis remains the major cause of pericardial effusion, but neoplastic pericardial effusions are on the rise. Pericardial drainage or pericardectomy are often required for symptomatic relief in those with malignancy-caused pericardial effusion. 展开更多
关键词 pericardial effusion malignancy tuberculosis management
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