肺结核患者血清caspase-3活性研究

Serum Caspase-3 Activity in Tuberculosis Patients

目的：观察肺结核患者血清 caspase-3活性。方法选取广西医科大学第一附属医院感染科2010年12月住院肺结核患者38例，其中肺结核初治结核杆菌痰涂片阳性13例、肺结核初治结核杆菌痰涂片阴性15例、肺结核复治耐药10例，于入院次日采集外周静脉血，同时选取健康体检者22例为对照组采用分光光度法检测肺结核患者血清 caspase-3酶活力单位，即 caspase-3催化产生的4-硝基苯胺（pNA）的吸光度（A）。结果肺结核初治结核杆菌痰涂片阳性组、肺结核初治结核杆菌痰涂片阴性组、肺结核复治耐药组、正常对照组血清 caspase-3酶活力单位分别为37.15±5.06，50.38±6.29，45.32±3.32和23.89±2.29。各组之间 caspase-3活性差异具有统计学意义（F＝10.68，P＜0.01）。与正常对照组相比，肺结核初治涂阳组（q＝3.51，P＝0.016）、肺结核初治涂阴组（q＝7.5，P＜0.001）、肺结核复治耐药组（q＝5.34，P＝0.001） caspase-3活性差异具有统计学意义。肺结核患者各亚组（耐药组、涂阳组、涂阴组）之间 caspase-3活性差异无统计学意义（P＞0.05）。各组之间性别构成比[χ2＝0.38（DL＝3），P＝0.94]差异无统计学意义；各组之间年龄差异亦无统计学意义（F＝0.82，P＝0.49）。结论 caspase-3与肺结核发生和发展的过程密切相关，其机制可能通过 caspase-3的激活促进了病变细胞的细胞凋亡从而产生机体抗结核的免疫过程。

Objective To explore serum caspase-3 activity in pulmonary tuberculosis patients.Methods 38 tuberculosis pa-tients in Infectious Disease Department in the First Affiliated Hospital of Guangxi Medical University were recruited and the peripheral venous blood was collected in December,2010.Among them,sputum smear-positive patients which were first treated were 13,sputum smear-negative patients which were first treated were 15,10 cases were drug resistance.In addition, 22 unrelated healthy individuals from a routine health survey were enrolled as controls.Spectrophotometry was used to de-tect serum caspase-3 activity in tuberculosis patients,which was absorbancy-A of 4-nitroaniline generated by caspase-3.Re-sults The activity of caspase-3 in sputum smear-positive patients,sputum smear-negative patients,drug resistance patients, and healthy controls were 37.15±5.06,50.38±6.29,45.32±3.32 and 23.89±2.29,respectively.The caspase-3 activity was significantly different from each other （F=10.68,P〈0.01）.Compared with the healthy controls,the caspase-3 activity in sputum smear-positive patients （q=3.51,P=0.016）,sputum smear-negative patients （q=7.5,P〈0.001）,drug resist-ance patients （q=5.34,P=0.001）was significantly different.There was no statistical difference among sputum smear-posi-tive patients,sputum smear-negative patients and drug resistance pulmonary tuberculosis patients （P〉0.05）.In the same way,there was no significant difference in male/female ratio[χ2=0.38 （DL=3）,P=0.94]and mean age （F=0.82,P=0.49）among the four group.Conclusion Caspase-3 closely associated with the development of tuberculosis occurrence, which might promote apoptosis of cells through the activation of caspase-3 and produce the body immune process of tubercu-losis.