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2014欧洲低钠血症诊疗临床实践指南解读

肺隔离症误诊为脓胸一例

临床资料 患者女性, 21 岁。因“反复咳嗽1 年余”入院。患者1 年前无明显诱因出现咳嗽, 无痰, 无发热、盗汗、乏力。当地医院给予抗感染治疗症状缓解。以后患者反复出现干咳, 口服抗生素及止咳药好转。2 周前又出现干咳,到当地市立医院就诊。胸片示右侧胸腔积液; 胸腔彩超示右侧胸腔包裹性积液, 内部可见粗点状回声及分隔光带回。血白细胞11. 02 ×109 /L, 中性粒细胞0. 499, 淋巴细胞0. 408;胸腔穿刺共抽出30 mL 脓液, 查胸水白细胞11 400 ×106 /L,中性粒细胞0. 41, 淋巴细胞0. 59。给予头孢哌酮/ 舒巴坦3 g静脉滴注, 2 次/d, 治疗1 周, 患者仍干咳, 并出现右侧胸部不适。‥‥‥

Relationship between SerumIL-17, IL-8 Levels and BODE Index in Patients with Stable COPD

Objective To analyze the relationship of serum IL-17, IL-8 levels and BODE index in patients with stable COPD, and investigate the clinical value of serum IL-17 and IL-8 in evaluating disease severity and prognosis. Methods A comparative study was performed in40 clinically stable COPD patients and 40 matched healthy individuals. The serum levels of IL-17 and IL-8 in both groups were measured. Correlation analysis was performed between serum IL-17, IL-8 levels and BODE index in the patients with stable COPD. Results The serumlevels of IL-17 and IL-8 in the COPD group were ( 114. 02 ±34. 84) pg/mL and ( 102. 67 ±31. 55) pg/mL, increased significantly compared with those in the healthy group which were ( 73. 22 ±14. 66) pg/mL and ( 35. 36 ±5. 04) pg/mL ( P lt;0. 05) respectively. Both of serum IL-17 and IL-8 levels were positively correlated with BODE index in the patients with stable COPD ( r = 0. 782, r = 0. 924, P lt;0. 001) . Conclusions High levels of serumIL-17 and IL-8 implies active inflammation in patients with stable COPD. Detection of serumIL-17 and IL-8 can help evaluate disease severity and prognosis.