凝血-纤溶系统与胸腔积液

渗出性胸腔积液中凝血活性增强,纤溶活性受抑制,前者主要表现为凝血因子增加,后者以纤溶酶原激活物抑制剂增加为特征.此凝血-纤溶失衡可引起纤维蛋白沉积,导致胸膜纤维化.炎症因子可诱导凝血-纤溶失衡,后者也同时影响炎症过程.漏出性胸腔积液无炎症反应,无凝血-纤溶失衡,故很少引起胸膜纤维化.

Coagulation-fibrinolysis and pleural effusion

Coagulation activity increases, and fibrinolysis activity decreases in exudative pleural effusion. The blood coagulation factors increase in the former, and plasminogen activator inhibitors increase in the latter. This coagulation-fibrinolysis imbalance may cause fibrin deposition, resulting in pleural fibrosis. Inflammatory cytokines can induce coagulation-fibrinolysis imbalance, which also affect the inflammatory process. There is no inflammatory response and coagulation-fibrinolysis imbalance in transudative pleural effusion, which rarely causes pleural fibrosis.