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目的 通过检测不同病因胸腹水中内皮素-1(ET-1)和细胞间黏附分子1(ICAM-1)水平,探讨其在鉴别胸腹水性质中的意义。方法 83例来自临床上已确诊病人的胸腹水标本,分为三组:A.结核组(21例);B.恶性肿瘤组(29例);C.肝硬化组(33例)。采用放免法检测ET-1含量,酶联免疫吸附法(ELISA)测ICAM-1水平。结果 结核性腹水ICAM-1水平为129.67±39.72ng/L(x±s),肿瘤性腹水水平为72.63±32.75ng/L,肝硬化腹水水平为30.55±19.88 ng/L,结核性腹水ET-1水平为68.24±19.48 ng/L,肿瘤性腹水水平为42.17±16.40 ng/L,肝硬化腹水水平为22.46±16.77 ng/L,ICAM-1和ET-1水平在结核性腹水中明显高于肿瘤性腹水(P<0.05)和肝硬化性腹水(P<0.01),两者水平在肿瘤性腹水和肝硬化腹水之间的也存在显著性差异(P<0.05)。结论ICAM-1和ET-1的表达与机体炎症反应被激活及肿瘤的侵袭与转移有关,故结核性及肿瘤性胸腹水中ICAM-1和ET-1水平有不同程度的增高,ET-1及ICAM-1水平可作为一种筛选手段,以初步鉴别胸腹水的性质。
Objective To detect the levels of endothelin-1 (ET-1) and intercellular adhesion molecule-1 (ICAM-1) in pleural and peritoneal effusion of different etiology, and to explore its significance in the differential diagnosis of pleural effusion and ascites. Methods 83 cases of ascites from patients with clinically confirmed patients were divided into three groups: A. tuberculosis group (21 cases); B. malignant tumor group (29 cases); C cirrhosis group (33 cases). The content of ET-1 was detected by radioimmunoassay and the level of ICAM-1 by enzyme-linked immunosorbent assay (ELISA). Results The ICAM-1 level of tuberculous ascites was 129.67 ± 39.72ng / L (x ± s), the level of tumor ascites was 72.63 ± 32.75ng / L, the level of ascites of cirrhosis was 30.55 ± 19.88ng / 1 level was 68.24 ± 19.48 ng / L, tumor ascites level was 42.17 ± 16.40 ng / L, cirrhosis ascites level was 22.46 ± 16.77 ng / L, ICAM-1 and ET-1 levels were significantly higher in tuberculous ascites (P <0.05) and cirrhotic ascites (P <0.01). There was also significant difference between the two groups in tumor ascites and cirrhosis ascites (P <0.05). Conclusions The expression of ICAM-1 and ET-1 is related to the activation of the inflammatory reaction and the invasion and metastasis of the tumor. Therefore, the levels of ICAM-1 and ET-1 in tuberculous and tumorous pleural effusion are increased to some extent. The expression of ET-1 And ICAM-1 level can be used as a screening method to initially identify the nature of pleural effusion.