2型糖尿病并发肺结核患者血浆Th1/Th2型细胞因子研究

Plasma TH1/TH2 Cytokine Among Pulmonary Tuberculosis Patients Complicated With Type 2 Diabetes Mellitus

目的分析2型糖尿病并发肺结核(T2DM-PTB)患者血浆中干扰素-γ(IFN-γ)和白介素-4(IL-4)的分布及其影响因素。方法研究对象分为4组:2型糖尿病并发肺结核组(并发组)、肺结核(PTB)组、2型糖尿病(T2DM)组和健康对照组(Hco组),每组40例。采用酶联免疫吸附(ELISA)法测定各组血浆中IFN-γ和IL-4水平,并采用多元线性回归模型分析影响2者分布的相关因素。结果IFN-γ浓度表现为并发组>TB组>T2DM组>Hco组,组间差异有统计学意义,IL-4在4组间未见差异;血糖控制差、未治疗糖尿病、患糖尿病后减重多、肺部空洞同血浆IFN-γ存在正关联,糖尿病微血管并发症、调查时体质指数与其存在负关联。结论T2DM-PTB患者血浆中Thl/Th2应答有所上调,此上调与血糖控制差、TB病理损伤有关,但2者间孰因孰果尚待研究。

Objective To evaluate the distribution and correlated factors of Interferon-γ（IFN-γ） and Intedeukin-4（IL-4） in the plasma of pulmonary tuberculosis complicated with type 2 diabetes（T2DM-PTB）. Methods The level of IFN-γand IL-4 in plasma were measured with ELISA and compared for four groups： T2DM- PTB group, PTB group, T2DM group and healthy control （Hco） group. Results IFN-γ showed significantly increase by the pattern of T2DM-PTB 〉 PTB 〉 T2DM 〉 Hco, and differences had statistical significance. There was no significant difference of IL-4 level among four groups. Poor glucose control, untreated for DM, weight loss caused by DM, and lung cavity correlated with IFN-3t positively, while microvascular complications of DM and BMI had negative correlation with it. Conclusions T2DM-PTB patients showed up-regulation of Th1/Th2 respond in plasma which might be related to poor glucose control and PTB pathological damage, but further study is needed on the causality of this phenomenon.