FIBRINOLYTIC AND INFLAMMATORY PROCESSES IN PLEURAL EFFUSIONS

被引：98

作者：

PHILIPJOET, F ^{[1
]}

ALESSI, MC ^{[1
]}

PHILIPJOET, C ^{[1
]}

AILLAUD, M ^{[1
]}

BARRIERE, JR ^{[1
]}

ARNAUD, A ^{[1
]}

JUHANVAGUE, I ^{[1
]}

机构：

[1] FAC MED MARSEILLE,INSERM,CJF 9312,HEMATOL LAB,F-13385 MARSEILLE,FRANCE

来源：

EUROPEAN RESPIRATORY JOURNAL | 1995年 / 8卷 / 08期

关键词：

CANCER; CARDIAC FAILURE; EMPYEMA; FIBRINOLYSIS; PLEURAL EFFUSION; TUBERCULOSIS;

D O I：

10.1183/09031936.95.08081352

中图分类号：

R56 [呼吸系及胸部疾病];

学科分类号：

摘要：

This study was designed to evaluate major fibrinolytic parameters in relation to parameters of inflammation associated with different kinds of pleural effusion. Sixty patients with pleural effusion were studied. The underlying aetiology was empyema in 10 cases, tuberculosis in 9, cancer in 31, cardiac failure in 7, and undetermined in 3. Plasminogen, plasminogen activator inhibitor 1 (PAI-1) and 2 (PAI-2), tissue type plasminogen activator (t-PA), urokinase (u-PA) and D-dimers (D-D) were quantified in plasma samples and pleural effusion specimens. These data were then correlated with inflammatory or infectious parameters, i.e. fibrinogen, von Willebrand factor (VWF), erythrocyte sedimentation rate (ESR), protein concentration, and white blood cell count. D-D levels were higher in pleural fluid than in plasma, D-D levels were not correlated with either plasminogen activator or plasminogen activator inhibitor levels, suggesting the presence of other fibrinolytic pathways. PAI levels (PAI activity, PAI-1 antigenicity, PAI-2 antigenicity) and vWF levels were significantly higher in patients with tuberculosis and empyema than in patients with cancer or cardiac failure, Regression analysis between inflammatory and fibrinolytic parameters showed that pleural PAI levels were significantly correlated with pleural neutrophil count, vWF levels, and plasma fibrinogen levels, D-D levels were correlated with blood ESR. No significant difference in pleural t-PA, u-PA and D-D levels was observed between aetiologies. The highest pleural t-PA and u-PA values were noted in patients with cancer, especially lymphoma. Plasma t-PA levels were higher in patients with pleural effusion secondary to congestive heart failure, but this difference did not reach statistical significance. In conclusion, pleural PAI levels are related to polymorphonuclear count and vWF levels, ie. to inflammatory processes. Elevated levels of plasminogen activators suggest a possible role in some malignant pleural diseases.

引用

页码：1352 / 1356

页数：5