Acknowledgement
Supported by : 인하대학교
Background : The intrapleural hypofibrinolysis is caused by mainly excessive concentration of pleural plasminogen activator inhibitor-1 antigen(PAI-1 Ag), which binds tissue type plasminogen activator. In pleural inflammation induced by sclerosing agents for pleurodesis, levels of pleural PAI-1 antigen increase in relation to decreasing D-dimer levels. It has been known that the pleural mesothelial cells have the capability of secreting PAI-1 Ag in response to inflammation in vivo. Therefore, we estimated whether pleural inflammation changes the balance between fibrinolytic and coagulative properties in exudative pleural effusions. Method : The thirty cases was included in our study. We determined the pleural levels of glucose, lactic dehydrogenase(LDH), pH and the counts of white blood cell(WBC), polymorpho leukocyte(PMN), lymphocyte as the parameters of pleural inflammation and cellular components of pleural fluid. The plasma level of fibrinogen in fluid and the neutrophil count in blood were determined. The levels of D-dimer, PAI-1 Ag and thrombinantithrombin III complex(TAT) were determined by ELISA(Behring, Marburg, Germany). Result : The causes of pleural effusion were as following : tuberculous in 14 cases, malignant in 10 cases and parapneumonic in 6 cases. The levels of pleural D-dimer, PAI-1 Ag and TAT was significantly higher than that of plasma(p<0..001). The severity of pleural inflammation did not correlated with pleural D-dimer, PAI-1 Ag, TAT and their plasma levels. But the level of pleural TAT correlated with pleural WBC and lymphocyte count. Conclusion : We found that the severity of pleural inflammations did not correlated with pleural D-dimer, PAI-1 Ag, TAT and the possibility of local production of PAI-1 antigen is present.
연구배경 : Plasminogen activator inhibitor-l(PAI-1) 항원은 섬유소 용해에 관여하는 tissue type plasmingen activator(t-PA)를 억제하여 흉막액에 존재하는 섬유소가 용해되는 것을 억제하며 결국 흉막액의 응고를 촉진하게되며 패혈증 환자의 혈장에서 PAI-1 항원과 관계된 섬유소 용해능의 활성용 업종의 정도와 관계가 알려져 있슴으로 본 연구에서 흉막액내 염증 정도와 흉막액의 섬유소 용해 및 응고농 간의 상관관계를 알아보고자 하였다. 방 법 : 첫 흉막천자 후 얻어지는 검체와 검사 당일 환자의 혈액 3.8% citrate tube에 모은 후 즉시 2,000 rpm에서 30분간 원심 분리하였고 상층액을 분리하여 검사할 때까지 영하
Supported by : 인하대학교