P-选择素和内皮素-1检测在腹水鉴别诊断中的价值

目的:通过检测不同病因腹水中P-选择素(P-selectin)和内皮素-1(ET-1)的含量,探讨其在鉴别腹水性质中的意义。方法:83例来自临床上已确诊病人的腹水标本,分为3组:结核组(21例),恶性肿瘤组(29)和肝硬化组(33例)。采用酶联免疫吸附法(ELISA)检测P-选择素水平,放免法检测ET-1含量。结果:结核性腹水P-selec-tin水平为(9.27±1.55)ng/L,肿瘤性腹水水平为(4.89±1.38)ng/L,肝硬化腹水水平为(2.21±1.44)ng/L。结核性腹水ET-1水平为(68.24±19.48)ng/L,肿瘤性腹水水平为(42.17±16.40)ng/L,肝硬化腹水水平为(22.46±16.77)ng/L,P-selectin和ET-1水平在结核性腹水中明显高于肿瘤性腹水(P<0.05)和肝硬化性腹水(P<0.01),两者水平在肿瘤性腹水和肝硬化腹水之间的也存在显著性差异(P<0.05)。结论:P-selectin和ET-1的表达与机体炎症反应被激活及肿瘤的侵袭与转移有关,故结核性及肿瘤性腹水中P-selectin和ET-1水平有不同程度的增高,P-selectin及ET-1水平可作为一种筛选手段,以初步鉴别腹水的性质。

Significance of P-selectin and ET-1 Levels in Differentiating the Aetiology of Ascites

Objective: To evaluate the levels of intercellular adhesion P-selectin and endothelin-1(ET-1) in neoplastic,cirrhotic and tuberculous ascites for differentiating in the aetiology.Methods: P-selectin levels were detected in ascitic fluid from 21 patients with tuberculous disease,29 patients with neoplasm,and 33 patients with cirrhosis by ELISA methods.ET-1 leves were detected with ET-1 radio immunity test Kit.Results: The level of P-selectin was(9.27±1.55) ng/L in tuberculous group,(4.89±1.38) ng/L in neoplastic group,and(2.21±1.44) ng/L in cirrhosis group.The level of ET-1 was(68.24±19.48) ng/L in tuberculous group,(42.17±16.40) ng/L in neoplastic ascites,and(22.46±16.77) ng/L in cirrhotic group.P-selectin and ET-1 in patients with tuberculous disease were much higher than those with neoplasm (P<0.05) and cirrhosis,and there was also a significant difference between neoplastic and cirrhotic group.(Conclusion:) P-selectin and ET-1 expression is related to inflammatory reaction activation and is involved in the incursion and metastasis of the neoplasm.So there would be some difference(among) different ascites.Detecting ET-1 and P-selectin in ascites might be helpful for differentiating in the aetiology.