肺结核患者细胞因子与病情严重程度的相关性研究

Significance of plasma cytokines expression in the different clinical phenotypes of TB patients

目的探讨血浆Th1和Th2细胞因子在肺结核不同临床表型的表达并探讨其意义。方法应用液相芯片(Luminex)技术检测165例肺结核患者外周血中IFN-γ、IL-2、IL-10、IL-12(P40)、IL-12(P70)、IL-13、IL-5、IL-6和TNF-α细胞因子的表达。据肺部病灶范围、肺部空洞不同临床表型进行分组分析。据病灶范围可分为≤2组、3-4组和≥5组;肺部空洞可分为空洞组和无空洞组。组间差异采用单因素方差检验,多重比较采用Dunnet或LSD分析。结果不同受累范围的患者IL-6和TNF-α组间比较有统计学差异(P<0.05)。在病灶多的组IL-5有升高趋势,IL-12P40有下降趋势。然而,结核患者中无空洞组和有空洞组测量的9种细胞因子均无统计学差异(P>0.05)。结论病灶范围较广的临床表型的肺结核与Th1/Th2平衡向Th2偏移有一定关系,但有无合并肺部空洞可能与Th1/Th2免疫紊乱无明显相关性。

Objective To discuss the expression and the significance of Th1 cells and Th2 cells cytokines of plasma in different clinical phenotype of tuberculosis of TB patients. Methods The peripheral blood plasma cyto- kines expression were detected by liquid phase chip （Luminex） technology in 165 pulmonary tuberculosis （TB） pa- tients which included the expression of cytokines of IFN-γ, IL-2, IL-10, IL-12 （P40） , IL-12 （P70） , IL-13, IL-5, IL-6 and TNF-α. According to the scopes of pulmonary lesions and the cavities of pulmonary in different clinical phe- notype, patients were divided into different groups. They were divided into 1 - 2 sets, 3 - 4 sets and 5 - 6 sets of lung field groups, according to the scopes of lesions of the pulmonary. And they were divided into the no cavity group and the cavity group. Results The levels of IL-6 and TNF-α were significantly different among the difference scope of lesions groups （ P 〈 0. 05 ）. With the increasing of lesions group, IL-5 and IL-12 p40 had a downward trend. How- ever, there was no statistical difference in the nine cytokines between the no cavity group and the cavity group （ P 〉 0.05 ）. Conclusion With the more scopes of lesions of pulmonary tuberculosis patients, Th1/Th2 balance has certain relation with the deviation of Th2 cytokines, but the cavities of pulmonary TB patients might have no obvious correlation with Th1/Th2 balance.