COPD合并肺结核患者TNF-α和IFN-γ与sIL-2R及CRP的表达

Expression of TNF-α, IFN-γ, sIL-2R and CRP in COPD patients complicated with pulmonary tuberculosis

目的 分析慢性阻塞性肺疾病(COPD)合并肺结核(PTB)患者肿瘤坏死因子-α(TNF-α)、干扰素-γ(IFN-γ)、可溶性白细胞介素-2受体(sIL-2R)、C-反应蛋白(CRP)的表达。方法 选取2016年3月-2019年3月重庆市梁平区人民医院呼吸与危重症医学科收治的COPD急性期合并PTB活动期(A组)、COPD急性期合并PTB恢复期(B组)、COPD稳定期合并PTB活动期(C组)、COPD稳定期合并PTB恢复期(D组)、单纯COPD稳定期组、单纯PTB恢复期组、单纯COPD急性期组、单纯PTB活动期组患者各25例及同期25名常规体检者作为对照组,比较各组血清TNF-α、IFN-γ、sIL-2R、CRP水平,并对数据进行统计分析。结果 各病例组TNF-α、IFN-γ、sIL-2R、CRP均高于对照组(P<0.05);单纯COPD稳定期组、单纯COPD急性期组、单纯PTB恢复期组、单纯PTB活动期组、D组、B组、C组、A组血清TNF-α、IFN-γ、sIL-2R、CRP依次升高(P<0.05);病情好转者血清TNF-α、IFN-γ、sIL-2R、CRP均较治疗前降低(P<0.05);TNF-α、IFN-γ、sIL-2R、CRP预测病情恶化AUC为0.706、0.718、0.768、0.807。结论 PTB合并COPD患者血清TNF-α、IFN-γ、sIL-2R、CRP明显异常,TNF-α、IFN-γ、sIL-2R、CRP均与疾病严重程度有关,对病情恶化具有较高预测价值。

OBJECTIVE To explore the expression of tumor necrosis factor-α(TNF-α), interferon-γ(IFN-γ), soluble interleukin-2 receptor(sIL-2 R) and C-reactive protein(CRP) in chronic obstructive pulmonary disease(COPD) patients complicated with pulmonary tuberculosis(PTB). METHODS From Mar 2016 to Mar 2019, the acute stage of COPD patients complicated with active stage of PTB who were treated in the department of respiratory and critical care medicine of the People’s Hospital of Liangping District, Chongqing were assigned as the group, the acute stage of COPD patients complicated with recovery stage of PTB were assigned as the group B, the stable stage of COPD patients complicated with active stage of PTB were assigned as the group C, and the stable stage of COPD patients complicated with recovery stage of PTB were assigned as the group D. 25 patients with simple stable stage of COPD, 25 patients with simple recovery stage of PTB, 25 patients with simple acute stage of COPD, 25 patients with simple active stage of PTB and 25 people who received physical examination were chosen as the control group. The serum TNF-α, IFN-γ, sIL-2 R and CRP were observed and compared among the groups, and the data were statistically analyzed. RESULTS The levels of TNF-α, IFN-γ, sIL-2 R and CRP of the case groups were significantly higher than those of the control group(P<0.05). The levels of serum TNF-α, IFN-γ, sIL-2 R and CRP of the simple stable stage of COPD group, the simple acute stage of COPD group, the simple recovery stage of PTB group, the simple active stage of PTB group, the group D, the group B, the group C and the group A were elevated successively(P<0.05). The levels of serum TNF-α, IFN-γ, sIL-2 R and CRP of the patients with improved illness condition were reduced after treatment. The AUCs of the TNF-α, IFN-γ, sIL-2 R and CRP were respectively 0.706, 0.718, 0.768 and 0.807 in prediction of deterioration of disease. CONCLUSION The PTB patients complicated with COPD show abnormal expression of serum TNF-α, IFN-γ, sIL-2 R and CRP. The TNF-α, IFN-γ, sIL-2 R and CRP are associated with the severity of disease and have high value in prediction of the deterioration of disease.