外周血Blimp1、IFN-γ、IL-10水平与重症肺结核的相关性分析

Correlation analysis of peripheral blood Blimp1,IFN⁃γand IL⁃10 levels and severe pulmonary tuberculosis

目的研究外周血B淋巴细胞诱导成熟蛋白1(Blimp1)、γ-干扰素(IFN-γ)、白细胞介素-10(IL-10)水平与重症肺结核(PTB)患者预后的相关性。方法收集本院2018年1月至2019年3月结核内科收治的重症肺结核患者92例作为研究对象,另选择同期来本院体检的42例正常健康人作为对照组。所有研究对象均采集空腹外周血标本,检测其单个核细胞Blimp1、IFN-γ、IL-10水平,分析上述因子与重症肺结核患者临床病理参数和预后的相关性。结果研究组患者Blimp1、IFN-γ、IL-10水平显著高于对照组,差异具有统计学意义(P<0.05);急性生理与慢性健康(APACHE-Ⅱ)评分≥21分、多器官功能障碍评分(MODS)≥5分和预后差的患者Blimp1、IFN-γ、IL-10水平显著高于APACHE-Ⅱ评分<21分、MODS评分<5分和预后良好患者,差异具有统计学意义(P<0.05);单因素以及多因素Cox回归分析均证实高Blimp1、高IFN-γ、高IL-10、APACHE-Ⅱ评分≥21分和MODS评分≥5分均是导致重症肺结核患者预后不良的独立危险因素(P<0.05)。结论重症PTB患者外周血单个核细胞Blimp1、IFN-γ、IL-10水平呈高表达状态,且其高表达与预后密切相关。

Objective To investigate the correlation between peripheral blood B lymphocyte in⁃duced maturation protein⁃1(Blimp1),interferon⁃gamma(IFN⁃γ)and interleukin⁃10(IL⁃10)levels and the prognosis of patients with severe pulmonary tuberculosis(PTB).Methods A total of 92 patients with severe pulmonary PTB who were admitted to Tuberculosis Internal Medicine in the hospital between January 2018 and March 2019 were recruited as the research subjects,and 42 normal healthy people who came to the hospital for physical examination during the same period were selected as the control group.The fasting peripheral blood samples of all subjects were collected to detect Blimp1,IFN⁃γ and IL⁃10 levels in mononuclear cells.The corre⁃lations between above⁃mentioned factors and clinical pathological parameters and prognosis of patients with se⁃vere pulmonary PTB were analyzed.Results The Blimp1,IFN⁃γ and IL⁃10 levels in the study group were sig⁃nificantly higher than those in the control group,with statistically significant differences(P<0.05).The Blimp1,IFN⁃γ and IL⁃10 levels in patients with acute physiology and chronic health evaluationⅡ(APACHEⅡ)scores≥21 points,MODS score≥5 points and poor prognosis were significantly higher than those in pa⁃tients with APACHEⅡscore<21 points,MODS score<5 points and good prognosis,with statistically signifi⁃cant differences(P<0.05).Univariate and multivariate Cox regression analyses confirmed that high Blimp1,high IFN⁃γ,high IL⁃10,APACHE⁃Ⅱscore≥21 points and MODS score≥5 points were independent risk fac⁃tors leading to poor prognosis of patients with severe pulmonary PTB(P<0.05).Conclusion The Blimp1,IFN⁃γ and IL⁃10 levels in peripheral blood mononuclear cells are elevated in patients with severe PTB,and their high expression is closely related to the prognosis.