RESUMEN
The aim of this study was to investigate the value and significance of interleukin-8 in differentiation of uncomplicated parapneumonic effusion (UCPPE) from complicated parapneumonic effusion (CPPE). Using an IMMULITE 1000 Analyzer, with chemiluminescent immunometric assay, levels of interleukin-8 (IL-8) were measured in the pleural fluid of patients with UCPPE (n=30), and CPPE (n=30), and three classical parameters (pH, glucose, and LDH) in these two groups. Receiver-operating curves were to assess the sensitivity and specifity of interleukin-8 for differentiating between the two patient groups. IL-8 levels were statistically higher in the CPPE group. A positive significant correlation, was found between levels of IL-8 and and lactate dehydrogenase (LDH) (r=0.68, p<0.05). There was also a positive significant correlation between IL-8 and protein level in pleural effusion (r=0.306, r<0.01). There was a significant negative correlation between levels of IL-8 and pH (r=-0.83, p<0.05), and of IL-8 and glucose in pleural fluid (r=-0.61, p<0.05). A cut-off value of 1805.81 pg/ml, differentiated CPPE from UPPE with a sensitivity of 100% and a specifity of 98%. IL-8 may be used as an alternative marker for the complication of parapneumonic effusion.
Asunto(s)
Interleucina-8 , Derrame Pleural , Neumonía/complicaciones , Adulto , Anciano , Biomarcadores/análisis , Biomarcadores/metabolismo , Diagnóstico Diferencial , Femenino , Glucosa/análisis , Humanos , Concentración de Iones de Hidrógeno , Interleucina-8/análisis , Interleucina-8/metabolismo , L-Lactato Deshidrogenasa/análisis , Masculino , Persona de Mediana Edad , Derrame Pleural/diagnóstico , Derrame Pleural/etiología , Derrame Pleural/metabolismo , Pronóstico , Reproducibilidad de los Resultados , Sensibilidad y Especificidad , Estadística como AsuntoRESUMEN
UNLABELLED: The fibrinopurulent phase of pleural empyema has very often been treated with thoracotomy and decortications. MATERIAL AND METHODS: We analyzed the lung function of 19 surgically treated patients in the last 3 years. The lung function was followed up at least 6 months after surgery. RESULTS: Before surgery the expected mean forced vital capacity (FVC) was 4650 ml, the expected mean forced expiratory volume in the first second (FEV1) was 3450 ml, the realized mean FVC was 2850 ml, and the realized mean FEV1 was 1750 ml. The mean FVC 3 months after surgery was 3430 ml, and the mean FEV1 was 1700 ml. The mean FVC 6 months after surgery was 3850 ml, and the mean FEV1 was 2950 ml. DISCUSSION: Early detection and treatment is essential in the treatment of empyema, where the use of thoracic drainage with or without streptokinase or the use of video-assisted thoracoscopic (VATS) decortication were methods of choice in treatment. Later, thoracotomy with decortication was the only treatment solution of the fibrinopurulent phase of empyema, where a trapped lung was frequently detected. CONCLUSION: Thoracotomy with decortication is a useful method of treatment of the fibrinopurulent phase of empyema, which solved the problem and also significantly improved lung function, especially at the follow-up after 6 months.