Sanad Mohammed, Shouman Waheed, Gharib Amal F
Department of Pediatrics, Faculty of Medicine, Zagazig University, Egypt.
Iran J Pediatr. 2011 Sep;21(3):278-86.
Angiopoietins are involved in the pathogenesis of a variety of human diseases. We tried to evaluate the application of pleural and serum Angiopoietin-1 and 2 in categorizing pleural effusions (PEs) into exudates and transudates in children.
Pleural fluid (PF) and serum Angiopoietin (Ang)-1 and Ang-2 were measured in 80 children with PEs (40 transudative and 40 exudative) by using enzyme-linked immunosorbent assay.
PF Ang-2 levels were significantly higher in pleural exudates than in transudates (P 0.012). PF Ang-2 levels were significantly higher than serum Ang-2 levels in patients with pleural exudates and transudates (P<0.001). PF Ang-2 levels were higher in tuberculous than in non-tuberculous pneumonic PEs and empyema (P=0.01). PF Ang-2 levels correlate with serum Ang-2 levels (P<0.003). PF Ang-1 levels were significantly lower than serum Ang-1 levels both in patients with exudates and those with transudates (P<0.001). Cutoff points of serum and PF Ang-2, differentiating between transudative and exudative effusions were 3ng/ml and 8ng/ml respectively. Predictive potentials of serum and PF Ang-2 cutoff points were: Sensitivity 90% and 95% respectively, specificity 92.50% and 97.50% respectively, positive predictive value 92.30% and 97.40% respectively and negative predictive value 90.20% and 95.10% respectively.
Ang-2 levels were elevated in exudative PEs and correlated with levels of markers of pleural inflammation and pleural vascular hyperpermeability. It could categorize PE to exudates and transudates with valuable discriminative properties. That was detected more obviously in pleural fluids than in serum.
血管生成素参与多种人类疾病的发病机制。我们试图评估胸膜和血清血管生成素-1及血管生成素-2在儿童胸腔积液（PE）分类为渗出液和漏出液中的应用。
采用酶联免疫吸附测定法检测80例患有PE的儿童（40例漏出液和40例渗出液）的胸水（PF）及血清血管生成素（Ang）-1和Ang-2。
胸膜渗出液中的PF Ang-2水平显著高于漏出液（P = 0.012）。胸膜渗出液和漏出液患者的PF Ang-2水平均显著高于血清Ang-2水平（P<0.001）。结核性胸腔积液中的PF Ang-2水平高于非结核性肺炎性胸腔积液和脓胸（P = 0.01）。PF Ang-2水平与血清Ang-2水平相关（P<0.003）。渗出液和漏出液患者的PF Ang-1水平均显著低于血清Ang-1水平（P<0.001）。区分漏出液和渗出液的血清及PF Ang-2的截断点分别为3ng/ml和8ng/ml。血清和PF Ang-2截断点的预测潜力分别为：敏感性分别为90%和95%，特异性分别为92.50%和97.50%，阳性预测值分别为92.30%和97.40%，阴性预测值分别为90.20%和95.10%。
渗出性胸腔积液中Ang-2水平升高，且与胸膜炎症和胸膜血管高通透性标志物水平相关。它可将胸腔积液分类为渗出液和漏出液，具有重要的鉴别特性。在胸水中比在血清中检测得更明显。
