γ干扰素、IL-4、C反应蛋白与结核性胸膜炎胸膜粘连的关系

Relationship among IFN-γ、IL-4、CRP and tuberculous pleurisy adhesions

目的 探讨胸腔积液γ干扰素（IFN-γ）、IL-4、C反应蛋白（CRP）与结核性胸腔积液胸膜粘连的关系.方法 选取2011年9月至2013年9月间于济南市第五人民医院呼吸内科住院治疗的经内科胸腔镜确诊的76例结核性胸膜炎患者,对其胸腔积液及血清中IFN-γ、IL-4水平、CRP的浓度进行测定.依据内科胸腔镜检查镜下观察胸膜粘连情况,将结核性胸腔积液进一步分为粘连组（43例）和游离组（33例）.结果 粘连组胸腔积液IFN-γ、CRP水平显著高于游离组（t=10.45、2.06,P＜0.05或＜0.01）;粘连组胸腔积液IL-4水平与游离组差异无统计学意义（t =0.11,P＞0.05）,两组血清IFN-γ、IL-4、CRP水平差异无统计学意义（t=1.47、1.27、1.01,均P＞0.05）.结论 结核性胸膜炎胸膜粘连与胸腔积液IFN-γ、CRP水平密切相关,结核性胸膜炎局部免疫及炎症反应增强,过强免疾反应易导致胸膜粘连;参与免疫反应的淋巴细胞亚群及细胞因子释放比例失衡可能参与胸膜粘连的形成.

Objective To investigate the relationship between the pleural effusion IFN-gamma,IL-4,C reactive protein （CRP） and tuberculosis pleural effusion pleural adhesion.Methods 76 cases of patients with tuberculous pleurisy pleural were selected from 2011 September to 2013 September in the department of internal medicine of the Fifth People＆#39;s Hospital of Jinan city.IFN-γ,IL-4 levels,CRP of effusion and serum were detected.According to the department of internal medicine thoracoscopy pleural adhesions which were observed under the microscope,patients were further divided into adhesion group （43 cases） and free group （33 cases）.Resnlts IFN-gamma,CRP level of pleural effusion in adhesion was significantly higher than that in free group （t =10.45,2.06,P 〈0.05 or 〈0.01）;IL-4 levels was not significantly different between two groups （t =0.11,P 〉 0.05）.There was no significant difference between the two groups of serum IFN-,IL-4 and CRP levels of gamma （t =1.47,1.27,1.01,all P 〉0.05）.Conclusions Tuberculous pleurisy pleural adhesion and pleural effusion IFN-γ,is closely related to CRP levels.Tuberculous pleurisy enhanced local immune and inflammatory response,which caused pleural adhesions;Involved in the immune response of lymphocyte subsets and cytokine release imbalance may be involved in the formation of pleural adhesions.