布鲁菌病患者Th1细胞免疫相关细胞因子的研究

Cytokines related to Thl immune response in patients with brucellosis

目的通过测定布鲁菌病患者血清中肿瘤坏死因子一α（TNF-α）、干扰素-γ（IFN-γ）的含量，了解急、慢性布鲁菌病患者Th1细胞免疫功能状态的不同。方法2014年6月至2015年6月，对张家口市传染病医院收治的110例布鲁菌病患者（其中急性期患者58例，慢性期患者52例）血清中TNF-α、IFN-γ含量测定，并比较治愈率。测定方法采用双抗体夹心（ABC）-酶联免疫吸附试验（ELISA）法。结果急性期布鲁菌病患者血清中TNF-α、IFN-γ含量分别为（38．2±3．6）pg／L、（31.3±3．7）ng／L，慢性期布鲁菌病患者血清中TNF-α、IFN-γ含量分别为（12．4±2．6）pg／L、（8．8±3．4）ng／L；急性期患者明显高于慢性期，两者比较差异有统计学意义（t=43．216、33．809，P均〈0．05）。急性期布鲁菌病患者治愈率为36．2％（21／58），基本治愈率为32．7％（19／58），好转率为25．9％（15／58），无效率为5．2％（3／58）；慢性期布鲁菌病患者治愈率为17.3％（9／52），基本治愈率为13．5％（7／52），好转率为15.4％（8／52），无效率为53．8％（28／52）。急性期患者治愈率和基本治愈率明显高于慢性期患者，两组比较差异有统计学意义（χ^2=4．937、5．657，P均〈0．05）。结论急性期布鲁菌病患者血清中TNF-α、IFN-γ含量高，Th1细胞免疫功能较强，有利于病菌的清除治愈率高；慢性期布鲁菌病患者血清中TNF-α、IFN-γ含量偏低，Th1细胞免疫功能较弱，机体清除病菌的能力不足，治愈率低。

Objective To detect the serum levels of tumor necrosis factor-alpha （TNF-α and interferongamma （IFN-γ） in brucellosis patients and to study the Thl immune response in acute and chronic patients. Method Serum levels of TNF-alpha and IFN-gamma of 110 brucellosis patients, including 58 acute brucellosis patients and 52 chronic brucellosis patients, were measured by enzyme linked immunosorbent assay （ELISA） from 2014 to 2015 in Zhangjiakou Infectious Disease Hospital. Results The serum levels of TNF-alpha and IFN-gamma of 58 acute brucellosis patients were （38.2 ± 3.6） pg/L and （31.3 ± 3.7） ng/L, respectively; the serum levels of TNF-alpha and IFN-gamma of 52 chronic brucellosis patients were （12.4 ±2.6） pg/L and （8.8 ± 3.4） ng/L, respectively. The differences were statistically significant between acute and chronic patients （t = 43.216, 33.809, all P 〈 0.05）. The early cure rate, early base cure rate, improvement rate and inefficiency rate were 36.2% （21/58）, 32.7% （19/58）, 25.9% （15/58）and 5.2% （3/58）, respectively in acute patients. Inversely, they were 17.3% （9/52）, 13.5% （7/52）, 15.4% （8/52）and 53.8% （28/52）, respectively in chronic patients. The therapeutic effect was better in acute patients than chronic patients （χ^2 = 4.937, 5.657, all P 〈 0.05）. Conclusion It seems that acute brucellosis patients have a higher serum levels of TNF-alpha and IFN-gamma and a better prognosis due to effective Thl immune response, and chronic brucellosis patients are associated with poor outcome due to deficiency of Thl immune response.