口服及胸腔注射糖皮质激素对结核性胸膜炎患者血清和胸腔积液中IL－6、IL－8和sIL－2R表达水平的影响被引量：1

Effect of gincocorticoid by oral medication or intrathoracic injection on the expression of IL-6, IL-8 and slL-2R in serum and pleural fluid in patients of tuberculous pleurisy

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摘要目的观察口服和胸腔注射糖皮质激素对结核性胸膜炎患者血清和胸腔积液中IL-6、IL-8和sIL-2R表达水平的影响。方法应用ELISA法检测口服用药组和胸腔注射组各20例患者用药前及用药后第3、6、9天外周血和胸腔积液中IL-6、IL-8和sIL-2R水平。结果口服用药组用药后第3、6、9天血清中IL-6、IL-8明显降低并显著低于胸腔注射组（P〈O．01），sIL-2R明显升高并显著高于胸腔注射组（P〈0．01）。胸腔注射组用药后第3、6、9天胸腔积液中IL-6、IL-8明显下降并显著低于口服用药组（P〈0．01），sIL-2R明显上升并显著高于口服用药组（p〈0．01）。用药1个月后，口服用药组胸腔积液完全吸收率45％（9／20），胸膜肥厚率40％（8／20），胸腔注射组分别为80％（16／20）、10％（2／20），两组比较差异有统计学意义（P〈0．05）。结论与口服糖皮质激素比较，胸腔内注射糖皮质激素对胸膜腔局部的细胞免疫功能具有更强的抑制作用，而对整个机体免疫功能的抑制显著减弱；胸腔内注射糖皮质激素对结核性胸膜炎患者具有更显著的疗效。 Objective To observe the effect of glucocorticoid by oral medication or intrathoracic injection on the expression of IL-6, IL-8 and sIL-2R in serum and pleural fluid in patients of tuberculous pleurisy. Methods Twenty tuberculous pleurisy patients were treated with glucocorticoid by oral medication （oral group） and 20 cases by intrathoracic injection （injection group）. ELISA was employed to detect the levels of IL-6, IL-8 and sIL-2R in serum and pleural fluid before treatment and 3, 6 and 9 days after treatment. Results The levels of serum IL-6 and IL-8 decreased and sIL-2R increased obviously in injection group at 3, 6 and 9 days after treatment（P 〈 0.01 ）. Meanwhile the levels of IL-6 and IL-8 in pleural fluid decreased and sIL-2R increased obviously （P 〈 0.01 ）. The levels of IL-6 and IL-8 were significantly lower and the levels of sIL-2R were significantly higher in injection group than those in oral group （P 〈 0.01 ）. One month after treatment, the rate of complete absorption of pleural fluid was higher in injection group（ 80% ）than that in oral group （45%）,the rate of pachynsis pleurae was lower in injection group （10%）than that in oral group（40%）, P 〈 0.05. Conclusions Intrathoracic injection of glucocorticoid shows stronger suppression of cellular immune function in cavum pleurae and weaker suppression of the general immune system than oral medication. Intrathoracic injection of glucocorticoid can increase the therapeutic effect and decrease side effect in tuberculous pleurisy.

作者郭榕高美华林存智李勇陈敏

机构地区青岛大学医学院免疫学教研室青岛市胸科医院结核科青岛大学医学院检验科北京市肿瘤防治研究所遗传室

出处《中国医师进修杂志（内科版）》 2009年第1期30-33,共4页 Chinese Journal of Postgraduates of Medicine

关键词结核胸膜糖皮质激素类白细胞介素6 白细胞介素8 受体白细胞介素2 Tuberculosis, pleura Glucocorticoids Interleukin-6 Interleukin-8 Recepter, interleukin-2

分类号 R542.22 [医药卫生—心血管疾病] R521.7 [医药卫生—内科学]

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