Thrombin-antithrombin III complex, proinflammatory cytokines, and fibrinolytic indices for assessing the severity of inflammation in pleural effusions

This study investigated coagulation-related variables, proinflammatory cytokines, and fibrinolytic indices to assess the severity of inflammation in patients with pleural effusions. Tuberculous pleural fluids revealed significantly higher concentrations of tumor necrosis factor-α (TNF-α) and plasminogen activator inhibitor type I (PAI-1) than did malignant and pneumonic pleural fluids. Among the coagulation-related variables, thrombin-antithrombin III complex (TAT) exhibited the largest difference in mean values between pleural fluids and blood samples (125.4 ± 45.1 vs 14.3 ± 20.3 ng/ml, p <0.05). Inflammatory parameters were more closely associated with TAT than tissue type plasminogen activator (tPA), PAI-1, and D-dimers. TAT levels in the severe inflammation group (153.8 ± 45.6 ng/ml) were significantly above those in the mild inflammation group (105.6 ± 38.5 ng/ml, p <0.05); however, no significant differences were observed in PAI-1 and D-dimers levels between the two groups. In conclusion, TNF-α and PAI-1 are important indicators in patients with tuberculous pleural effusions, and measurement of TAT is useful for assessing the severity of inflammation in pleural fluids.