Antony V B, Mohammed K A
Department of Medicine, Indiana University School of Medicine, Indianapolis 46202, USA.
Semin Respir Infect. 1999 Mar;14(1):9-17.
The pleura responds to the presence of infecting organisms with a vigorous inflammatory response associated with an exudation of white blood cells and proteins. Changes in pleural permeability lead to formation of an exudative pleural effusion. The pleural mesothelial cell is the primary cell lining the pleural space and, when activated by the presence of organisms, initiates the inflammatory response by releasing a battery of chemokines and cytokines. Mesothelial cells are actively phagocytic and also release oxidants and proteases. The acute inflammatory process may resolve with appropriate antibiotic therapy and drainage leaving minimal fibrosis. However, under certain circumstances vigorous pleural fibrosis with scarring and loss of delineation of pleural surfaces can occur. Recognition of the stage of development of the empyema is an important clinical judgement that can affect outcome. The pathogenesis of infections of the pleural space and the role played by the various cell types is delineated in this article.
胸膜对感染性生物体的存在会产生强烈的炎症反应，伴有白细胞和蛋白质渗出。胸膜通透性的改变导致渗出性胸腔积液的形成。胸膜间皮细胞是胸膜腔的主要内衬细胞，当被生物体激活时，会通过释放一系列趋化因子和细胞因子引发炎症反应。间皮细胞具有活跃的吞噬作用，还会释放氧化剂和蛋白酶。急性炎症过程可通过适当的抗生素治疗和引流得以缓解，仅留下极少的纤维化。然而，在某些情况下，可能会发生严重的胸膜纤维化，伴有瘢痕形成和胸膜表面界限不清。识别脓胸的发展阶段是一项重要的临床判断，可能会影响治疗结果。本文阐述了胸膜腔感染的发病机制以及各种细胞类型所起的作用。
