肺结核患者血细胞因子水平与肺纤维化的相关性研究

A study on the correlation between serum cytokines level and lung fibrosis in pulmonary tuberculosis

目的评价6种血清细胞因子与肺纤维化及其功能损害程度间的关系。方法测定133例肺结核患者的肺功能、胸部HRCT和血细胞因子，根据肺功能结果分为正常组（47例）、限制性轻度减退组（36例）、限制性显著减退组（25例）和限制性严重减退组（25例）。并计算反映肺纤维化程度的HRCT分值。结果肺功能4组中，血清细胞因子IL-1、IL-2、IL-5、IL-6、IFN-T、TNF-α的均值经检验H值分别为101．282、96．454、0．990、0．538、102．300、97．715，提示IL-1、IL-2、IFN-T、TNF-α的均数在4组间的差异有统计学意义（p＝0．000）。HRCT分值的变化范围是1～15分，IL-1、TNF-α与HRCT分数呈显著正相关（分别为R＝0．757 P=0．000，R=0．972 P=0．000），而IL-2、IFN-T与HRCT分数呈显著负相关（分别为R=-0．738 P=0．000，R=-0．750 P=0．000），IL-5、IL-6与HRCT分数无关（分别为R=0．102 P=0．241，R=0．048 P=0．584）。按HRCT分数的大小，将133例病人分为低分组（99例）和高分组（34例），IL-1、TNF-α的均数在2组的差异有统计学意义（P=0．000）。各细胞因子之间也存在相互关系，其中IL-1和TNF-α，IL-5和IL-6以及IL-2和IFN-τ之间关系密切，而且变化方向相同。IL-1和IL-2，IL-1和IFN-τ，IL-2和TNF-α以及IFN-τ和TNF-α之间关系亦非常密切，但变化方向相反。结论血清细胞因子与肺结核患者的肺功能、肺纤维化程度有相关性，其中IL-1、TNF-α的相关性最强。

Objective To evaluate the correlation between six serum cytokines and lung fibrosis, and damaged degree of lung function. Methods Serum cytokines, lung function and chest high-resolution computed tomography（HRCT） in 133 patients with pulmonary tuberculosis were detected. According to the result of lung function, all eases were divided into normal group （47 eases）, mild grade restrictive decrease group （36 cases）, moderate restrictive decrease group （25 cases） and severe restrictive decrease group （25cases）. The fibrosis extent was defined by score system of HRCT. Results Among 4 lung function groups, the H value of serum cytokines IL-1, IL-2, IL-5, IL-6, IFN-τ,TNF-αwere 101. 282, 96. 454, 0. 990, 0. 538,102. 300, 97. 715 respectively, with statistically significant differences of IL-1, IL-2, IFN-τ, TNF-α among the 4 groups（P=0. 000）. Total HRCT scores ranged from 1 to15. Significant positive correlations were observed be-tween HRCT score and IL-1, and TNF-α（R=0. 757 P=0. 000,R=0. 972 P=0. 000）, whereas neg- ative correlations were found in IL-2 and IFN-τ（R=-0. 738 P=0. 000,R=-0. 750 P=0.000）. There was no correlation between HRCT score and IL-5, IL-6 （R=0.102 P=0.241 ,R=0. 048 P= 0. 584）. 133 patients were divided into low score （99cases） group and high score （34cases） group according to HRCT score. The difference of mean between IL and TNF-α was significant by statis- tics（P=0. 000）. A correlation matrix for the different cytokines was evaluated one against another. Similar changes were observed between IL-1 and TNF-α; IL-5 and IL-6; IL-2 and IFN-τ. Howev- er, opposite changes were observed between IL-1 and IL-2; IL-land IFN-τ;IL-2and TNF-α. Con- clusions There is a significant correlation between serum cytokines and lung function, and lung fibrosis. IL-1 and TNF-α show the strongest correlation with them.