初诊活动性肺结核患者血浆IL-6,IL-17,IL-37及TIM-3水平表达及其临床意义

Expression and Clinical Significance of Plasma IL-6,IL-17,IL-37 and TIM-3 in Patients with Newly Diagnosed Active Pulmonary Tuberculosis

目的探讨初诊肺结核患者血浆白细胞介素-6(IL-6)、白细胞介素-17(IL-17)、白细胞介素-37(IL-37)及T细胞免疫球蛋白黏蛋白分子-3(TIM-3)水平变化及其临床意义。方法收集2018年1月~2020年10月百色市人民医院收治的活动性肺结核患者57例、肺炎患者50例和健康对照40例。57例肺结核患者中菌阳肺结核31例,菌阴肺结核26例。57例肺结核按病情轻重、病程长短及病变范围分为轻症组32例和重症组25例。采用酶联免疫吸附测定(ELISA)法检测各组血浆IL-6,IL-17,IL-37及TIM-3水平,并进行比较。结果肺结核组血浆IL-6(41.37±13.50 pg/ml vs 26.28±9.16pg/ml,3.05±1.08 pg/ml),IL-17(62.50±10.73pg/ml vs 30.47±7.18pg/ml,16.13±5.86pg/ml),IL-37(14.63±4.18pg/ml vs 9.85±2.74pg/ml,4.10±1.02 pg/ml)及TIM-3(18.17±5.16ng/ml vs 11.80±3.52ng/ml,6.24±2.15 ng/ml)水平均明显高于肺炎组和对照组,差异均有统计学意义(t=7.338~13.273,均P<0.001)。菌阳肺结核组血浆IL-6(52.60±15.71pg/ml vs 30.16±8.95 pg/ml),IL-17(72.35±15.20 pg/ml vs 46.52±9.13 pg/ml),IL-37(16.50±6.14 pg/ml vs 12.48±3.17 pg/ml)及TIM-3(21.70±7.93ng/ml vs 15.21±4.92 ng/ml)水平均明显高于菌阴肺结核组,差异具有统计学意义(t=8.472,10.161,6.925,9.106,均P<0.001)。重症组血浆IL-6(56.38±17.26pg/ml vs 25.84±9.27pg/ml),IL-17(79.50±16.38 pg/ml vs 48.20±8.74 pg/ml),IL-37(18.48±6.20 pg/ml vs 10.82±3.26pg/ml)及TIM-3(23.26±8.15ng/ml vs 13.90±4.71ng/ml)水平明显高于轻症组,差异具有统计学意义(t=12.642,14.513,10.205,13.172,均P<0.001)。结论血浆IL-6,IL-17,IL-37及TIM-3水平在肺结核患者中明显升高,对判断肺结核严重程度有一定的价值。

Objective To investigate the changes and clinical significance of plasma interleukin-6(IL-6),interleukin-17(IL-17),interleukin-37(IL-37)and T cell immunoglobulin mucin-3(TIM-3)levels in patients with newly diagnosed pulmonary tuberculosis.Methods The 57 patients with active tuberculosis,50 in the pneumonia group and 40 in the healthy control group were collected from People’s Hospital of Baise from January 2018 to October 2020.Among the 57 pulmonary tuberculosis patients,31 cases were in the positive pulmonary tuberculosis group and 26 cases were in the negative pulmonary tuberculosis group.The 57 cases of pulmonary tuberculosis were divided into mild group(32 cases)and severe group(25 cases)according to the severity of the disease,duration of the disease and lesion range.The levels of plasma IL-6,IL-17,IL-37 and TIM-3 were determined by enzyme-linked immunosorbent assay(ELISA),and the groups were compared.Results The levels of plasma IL-6(41.37±13.50pg/ml vs 26.28±9.16pg/ml,3.05±1.08 pg/ml),IL-17(62.50±10.73pg/ml vs 30.47±7.18pg/ml,16.13±5.86 pg/ml),IL-37(14.63±4.18pg/ml vs 9.85±2.74pg/ml,4.10±1.02 pg/ml)and TIM-3(18.17±5.16ng/ml vs 11.80±3.52ng/ml,6.24±2.15ng/ml)in tuberculosis group were significantly higher than those in pneumonia group and control group,the differences were statistically significant(t=7.338~13.273,all P<0.001).The levels of plasma IL-6(52.60±15.71 pg/ml vs 30.16±8.95 pg/ml),IL-17(72.35±15.20 pg/ml vs 46.52±9.13pg/ml),IL-37(16.50±6.14 pg/ml vs 12.48±3.17 pg/ml)and TIM-3(21.70±7.93ng/ml vs 15.21±4.92 ng/ml)in bacterial positive tuberculosis group were significantly higher than those in bacterial negative tuberculosis group,the differences were statistically significant(t=8.472,10.161,6.925,9.106,all P<0.001).The levels of plasma IL-6(56.38±17.26 pg/ml vs 25.84±9.27 pg/ml),IL-17(79.50±16.38pg/ml vs 48.20±8.74pg/ml),IL-37(18.48±6.20 pg/ml vs 10.82±3.26 pg/ml)and TIM-3(23.26±8.15ng/ml vs 13.90±4.71 ng/ml)in severe group were significantly higher than those in mild group the differences were statistically significant(t=12.642,14.513,10.205,13.172,all P<0.001).Conclusion The levels of plasma IL-6,IL-17,IL-37 and TIM-3 were significantly increased in patients with pulmonary tuberculosis,which has a certain value in judging the severity of pulmonary tuberculosis.