肺结核合并2型糖尿病患者血清炎性细胞因子的表达及其临床意义

Expression and clinical significance of serum inflammatory cytokines in patients with pulmonary tuberculosis complicated with type 2 diabetes mellitus

目的观察并初步分析肺结核合并2型糖尿病患者血清中炎性细胞因子白细胞介素-2(IL-2)、白细胞介素-10(IL-10)、γ干扰素(IFN-γ)、肿瘤坏死因子(TNF-α)的表达及临床意义。方法采用前瞻性研究,选取2015年11月至2016年11月海安市人民医院收治的2型糖尿病患者51例作为DM组,肺结核合并2型糖尿病患者48例作为TB+DM组,同期的健康体检者42例作为对照组。采集研究对象清晨空腹静脉血5 ml,采用酶联免疫吸附法检测各样本血清中IL-2、IL-10、IFN-γ、TNF-α的水平,进行对比。结果三组间的IL-2、TNF-α、INF-γ、IL-10水平比较,差异均具有统计学意义(P<0.05)。其中,TB+DM组的IL-2(0.215±0.152)μg/L、TNF-α(0.253±0.098)μg/L水平均低于DM组[(1.058±0.458)μg/L、(0.399±0.102)μg/L],INF-γ(33.560±2.370)μg/L、IL-10(1.331±0.241)μg/L水平均高于DM组[(6.010±6.730)μg/L、(0.835±0.301)μg/L],差异具有统计学意义(P<0.05)。TB+DM组和DM组的IL-2、TNF-α水平均低于对照组,INF-γ、IL-10水平均高于对照组,差异具有统计学意义(P<0.05)。结论检测患者血清中IL-2、IL-10、IFN-γ、TNF-α的水平对选取肺结核合并2型糖尿病指标诊断、评价该病的发生及病程,对治疗该病有着重要意义。

Objective To observe and analyze the expression and clinical significance of the serum inflammatory factors like IL-2,IL-10,IFN-γ,TNF-αin patients with pulmonary tuberculosis complicated with type 2 diabetes.Methods This study was conducted using prospective study method.A total of 141 patients with pulmonary tuberculosis complicated with type 2 diabetes admitted in Haian People’s Hospital between November 2015 and November 2016 were selected as research subjects.Among them,51 cases were type 2 diabetes(as DM group)and 48 cases were pulmonary tuberculosis complicated with type 2 diabetes mellitus(as TB+DM group),and 42 cases were healthy(control group)in the same hospital on corresponding period.Fasting venous blood 5 ml of the research objects was detected to measure the level of serum IL-2,IL-10,IFN-γ,TNF-αby enzyme-linked immunosorbent assay(ELISA)assays.Results The differences in the levels of IL-2,TNF-α,INF-γ,and IL-10 among the three groups were statistically significant(P<0.05).Among them,the levels of IL-2(0.215±0.152)μg/L and TNF-α(0.253±0.098)μg/L in TB+DM group were lower than those in DM group[(1.058±0.458)μg/L,(0.399±0.102)μg/L],and INF-γ(33.560±2.370)μg/L,IL-10(1.331±0.241)μg/L were higher than those in DM group[(6.010±6.730)μg/L,(0.835±0.301)μg/L],and the differences were statistically significant(P<0.05).The levels of IL-2 and TNF-αin the TB+DM group and DM group were lower than those in the control group,and the levels of INF-γand IL-10 were higher than those in the control group,and the differences were statistically significant(P<0.05).Conclusion The detection of the levels of IL-2,IL-10,IFN-γ,TNF-αin the serum of patients with pulmonary tuberculosis combined with type 2 diabetes is of great significance for the diagnosis and evaluation of the occurrence and course of the disease.