老年肺结核患者呼吸道感染病原菌分布与对干扰素γ及转录生长因子β水平的影响

Distribution of pathogens causing respiratory tract infections in elderly patients with pulmonary tuberculosis and its impact on levels of interferonγand transforming growth factor β

目的分析老年肺结核患者呼吸道感染病原菌分布,并研究其对干扰素(IFN)γ和转录生长因子(TGF)β水平的影响,为临床治疗提供参考。方法选取2010年5月-2014年8月医院诊治的220例老年肺结核合并呼吸道感染患者,设为感染组,应用全自动微生物鉴定仪VITEK-2Compact分析病原菌类型,以同期老年肺结核未感染患者110例设为未感染组和健康体检者110名为对照组,对3组调查对象血清中IFNγ和TGFβ水平变化及氧化应激蛋白p22、p47及p67变化进行统计分析。结果 220例老年肺结核合并呼吸道感染患者中分离病原菌220株,其中革兰阴性菌127株占57.7%,革兰阳性菌93株占42.3%;与健康对照组和未感染组患者相比,感染组患者血清中IFNγ及TGFβ水平明显升高,氧化应激蛋白p22、p47和p67表达增强,且差异有统计学意义(P<0.01)。结论老年肺结核患者呼吸道感染病原菌以革兰阳性菌为主,且能提高血清中IFNγ、TGFβ水平激活氧化应激蛋白表达。

OBJECTIVE To investigate the distribution of pathogens causing respiratory tract infections in elderly patients with pulmonary tuberculosis and observe the impact on the levels of interferon（IFN）γand transforming growth factor（TGF）βso as to provide guidance for clinical treatment.METHODS Totally 220 elderly pulmonary tuberculosis patients complicated with respiratory tract infections who were treated in the hospital from May 2010 to Aug2014were enrolled in the study and set as the infection group.The pathogens were identified by using automatic microorganism identification system VITEK-2Compact.During the same period,110 elderly pulmonary tuberculosis patients without infections were assigned as the non-infection group,and 110 healthy people who received the physical examination were chosen as the control group.The levels of serum IFNγand TGFβas well as the oxidative stress proteins p22,p47,and p67 of the three groups of subjects were statistically analyzed.RESULTS A total of 220 strains of pathogens were isolated from the 220 elderly pulmonary tuberculosis patients complicated with respiratory tract infections,including 127（57.7%）strains of gram-negative bacteria and 93（42.3%）strains of gram-positive bacteria.As compared with the control group and the non-infection group,the levels of serum IFNγand TGFβof the infection group were remarkably elevated,and the oxidative stress proteins p22,p47,and p67 were up-regulated,with statistical significance（P〈0.01）.CONCLUSIONThe gram-positive bacteria are dominant among the pathogens causing the respiratory tract infections in the elderly patients with pulmonary tuberculosis,which can make the levels of serum IFNγand TGFβelevated and activate the expression of the oxidative stress proteins.