肺结核患者免疫状态分析与临床研究

Clinical characteristics and immune state in patients with pulmonary tuberculosis

目的探讨结核感染、发病、转归过程中患者细胞免疫状态的连续变化及其对患者的病情、病程、疗效转归的影响。方法采用酶联免疫吸附试验(ELISA)分别测定潜伏感染者、现患者及健康未感染者血清中IFN-γ、IL-4、IL-17等相关细胞因子蛋白水平的动态变化。结果与健康对照组相比较,病例组血清中IL-4、IL-17水平明显升高,差异有统计学意义(P<0.01),而IFN-γ却明显降低,差异有统计学意义(P<0.01);潜伏感染组血清中IL-4、IL-17水平亦有升高,差异有统计学意义(P<0.01),IFN-γ亦降低,差异有统计学意义(P<0.01);且病例组血清中IL-4、IL-17水平高于潜伏组,差异有统计学意义(P<0.01),IFN-γ水平要低于潜伏组,差异有统计学意义(P<0.01)。结论部分细胞因子蛋白水平的动态变化,与患者病情、病程、疗效转归有紧密的关系,检测IFN-γ、IL-4、IL-17等有助于指导肺结核的治疗,为结核病的快速诊断和治疗提供了新思路。

Objective To investigate the continuous change of cellular immunity clinical characteristics,outcome and prognosis in tuberculosis patients. Methods Enzyme-linked immunosorbent assay （ELISA） was used to test the dynamic change of levels of IFN-γ, IL-4,IL-17 and other related cytokine protein in latent infection patients, the patients and healthy uninfected. Results Compared with healthy group,the levels of IL-4,IL-17 in the serum of patients group was significantly increased,the difference was statistically significant （P〈0.01）,and IFN-γ was significantly decreased,the difference was statistically significant （P〈0.01）;IL-4,IL-17 level in serum of latent infection patients group also increased, the difference is statistically significant （P〈0.01）,IFN-γ level also decreased,the difference was statistically significant （P〈0.01）;and IL-4,IL-17 level in the patients was higher than that in the incubation group,the difference was statistically significant （P〈0.01）,the level of IFN-γ was reduced than latent group,the difference was statistically significant（P〈0.01 ）. Conclusions The dynamic changes of cell factor protein levels are closely related to the patient＇s condition,course of disease, chnical outcomes. The detection of IFN- γ ,IL-4,IL-17 are helpful for guiding tuberculosis early diagnosis and treatment.