不同硬化剂所致全身炎症反应对胸膜固定术疗效的预测作用。
Systemic Inflammatory Response to Different Sclerosing Agents as a Predictor of Pleurodesis Outcome.
机构信息
Clinic of Chest Diseases, Immunology and Allergology, Institute of Clinical Medicine, Vilnius University, Vilnius, Lithuania;
Centre of Pulmonology and Allergology, Santaros Klinikos, Vilnius University Hospital, Vilnius, Lithuania.
出版信息
In Vivo. 2021 Jul-Aug;35(4):2391-2398. doi: 10.21873/invivo.12516.
BACKGROUND/AIM: The objectives of this study were to evaluate systemic inflammation using different sclerosing agents and to estimate the prediction of systemic inflammation for the efficacy of pleurodesis.
PATIENTS AND METHODS
Ninety-six patients with recurrent and symptomatic malignant pleural effusion were enrolled in this retrospective study. We used serum C-reactive protein (CRP) levels, serum leukocyte counts and neutrophil-to-lymphocyte ratios (NLRs) as parameters of systemic inflammatory reactions. Evaluations of these parameters were performed before and 24 h after pleurodesis.
RESULTS
Pleurodesis was successful in 81 (84.4%) patients. The non-graded talc induced the highest changes in serum CRP levels, total white blood cell and neutrophil counts compared to other agents, while mitoxantrone induced the lowest. Graded talc and bleomycin induced the same levels of changes in serum CRP levels and serum leukocyte counts. The change in serum NLR was the same for all agent groups. Logistic regression confirmed that a change in serum CRP levels [odds ratio (OR)=0.92, p=0.002] and previous chemotherapy (OR=3.31, p=0.012) were independent predictors of pleurodesis efficacy.
CONCLUSION
Pleurodesis agents induced a systemic inflammatory response at different levels. The change in serum CRP levels could be useful for predicting the success of pleurodesis.
背景/目的：本研究旨在评估不同硬化剂引起的全身炎症反应，并评估全身炎症反应预测胸腔粘连疗效的能力。
方法
本回顾性研究纳入了 96 例复发性有症状的恶性胸腔积液患者。我们使用血清 C 反应蛋白（CRP）水平、血清白细胞计数和中性粒细胞与淋巴细胞比值（NLR）作为全身炎症反应的参数。在胸腔粘连术前和术后 24 小时对这些参数进行评估。
结果
81 例（84.4%）患者的胸腔粘连成功。与其他药物相比，非分级滑石粉引起的血清 CRP 水平、总白细胞和中性粒细胞计数的变化最大，而米托蒽醌引起的变化最小。分级滑石粉和博来霉素诱导的血清 CRP 水平和血清白细胞计数变化相同。所有药物组的血清 NLR 变化相同。Logistic 回归证实，血清 CRP 水平的变化（OR=0.92，p=0.002）和先前的化疗（OR=3.31，p=0.012）是胸腔粘连疗效的独立预测因素。
结论
胸腔粘连剂引起不同程度的全身炎症反应。血清 CRP 水平的变化可用于预测胸腔粘连的疗效。
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