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目的通过研究胸腔积液患者发生胸膜纤维化时胸腔积液中乳酸脱氢酶(lactic dehydrogenase,LDH)水平与胸膜间皮细胞(pleural mesothelial cell,PMC)泛素蛋白mRNA量的表达,探索胸膜纤维化发生的可能机制。方法于2008年8月至2011年10月随机选取我院呼吸内科住院的良性胸腔积液患者174例,抽取良性胸腔积液患者的胸腔积液,分离胸膜间皮细胞进行原代细胞培养,细胞进行冻存。根据胸腔B超和胸片及CT判断是否发生胸膜纤维化,将上述胸腔积液患者分成两组,即胸膜纤维化组(23例)和无胸膜纤维化组(151例)。取两组胸腔积液原代胸膜间皮细胞分离。用实时荧光定量反转录-聚合酶链反应(RT-PCR)进行胸膜间皮细胞泛素蛋白mRNA表达的监测,并用L-P速率法测定LDH的表达量。比较胸膜纤维化组和无胸膜纤维化组胸膜LDH及间皮细胞泛素蛋白mRNA表达量的差异。结果胸膜纤维化组患者LDH含量为(317±47)U/L,明显高于无胸膜纤维化组[(281±54)U/L],差异有统计学意义(P<0.01),胸膜纤维化组患者间皮细胞泛素蛋白mRNA表达量(3.74±1.15)明显低于无胸膜纤维化组患者(42.95±2.90),差异有统计学意义(P<0.01)。结论胸膜纤维化的发生与胸膜炎症反应相关,在胸膜纤维化过程中,存在泛素化现象,可能存在间皮细胞的蛋白降解功能障碍,导致蛋白沉积,增加了胸膜纤维化的发生几率。
Objective To investigate the expression of lactic dehydrogenase (LDH) and ubiquitin mRNA in pleural mesothelial cells (PMC) in pleural effusion during pleural fibrosis in patients with pleural effusion. Possible mechanism of occurrence. Methods From August 2008 to October 2011, 174 patients with benign pleural effusion admitted to Department of Respiratory Medicine in our hospital were randomly selected. Pleural effusion was collected from patients with benign pleural effusion, and primary cultured cells were isolated from pleural mesothelial cells. Frozen. Pleural fibrosis was determined by pleural ultrasonography and chest radiography and CT. The pleural effusion was divided into two groups: pleural fibrosis (n = 23) and non-pleural fibrosis (n = 151). Take two groups of pleural effusion primary pleural mesothelial cells. The expression of ubiquitin mRNA in pleural mesothelial cells was detected by real-time quantitative reverse transcription-polymerase chain reaction (RT-PCR). The expression of LDH was detected by L-P rate assay. The difference of pleural LDH and mesothelial cell ubiquitin mRNA expression between pleural fibrosis group and non-pleural fibrosis group was compared. Results The LDH level in patients with pleural fibrosis was (317 ± 47) U / L, which was significantly higher than that in patients without pleural fibrosis [(281 ± 54) U / L], the difference was statistically significant (P <0.01) The expression of mesangial cell ubiquitin mRNA was significantly lower in patients with chemotherapy (3.74 ± 1.15) than in patients without pleural fibrosis (42.95 ± 2.90), the difference was statistically significant (P <0.01). Conclusions The occurrence of pleural fibrosis is associated with pleural inflammatory reaction. During pleural fibrosis, ubiquitination may occur and there may be dysfunction of protein degradation in mesothelial cells, resulting in protein deposition and increased incidence of pleural fibrosis.