CTD-ILD患者外周血清IL-6、TNF-α和IFN-γ的研究

Study on IL-6, TNF-α and IFN-γ in Peripheral Serum of Patients with CTD-ILD

目的:探讨外周血清白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)和γ干扰素(IFN-γ)在结缔组织病相关性肺间质病(CTD-ILD)中的临床价值。方法:回顾性分析2019年1月-2021年12月在南方医科大学深圳医院就诊的30例CTD患者(CTD组)和30例CTD-ILD患者(CTDILD组)的临床资料。收集CTD-ILD及CTD患者的临床症状,高分辨率CT扫描(HRCT)、细胞因子(IL-6、TNF-α及IFN-γ)检测结果、肺功能检查结果。并收集30例健康成人作为正常对照组,收集其外周血清标本,检测细胞因子(IL-6、TNF-α及IFN-γ)水平。结果:CTD-ILD组和CTD组外周血清中IL-6、TNF-α及IFN-γ水平均高于正常对照组(P<0.05);而CTD-ILD组IL-6和TNF-α均高于CTD组(P<0.05),而CTD-ILD组及CTD组的IFN-γ水平比较,差异无统计学意义(P>0.05)。CTD-ILD组不同原发疾病类型患者外周血清IL-6、TNF-α及IFN-γ水平比较,差异均无统计学意义(P>0.05)。CTD-ILD患者外周血清IL-6、TNF-α水平与FEV1%pred、DLCO%pred均呈负相关(P<0.05)。结论:检测IL-6和TNF-α水平有助于了解CTD-ILD患者的肺泡炎症的严重程度,且IL-6和TNF-α与肺功能密切相关,对判断和预测CTD-ILD病情具有重要的临床指导意义。

Objective: To investigate the clinical value of peripheral serum interleukin-6(IL-6), tumor necrosis factor α(TNF-α) and interferon-γ(IFN-γ) in connective tissue disease associated pulmonary interstitial disease(CTD-ILD). Method: The clinical data of 30 patients with CTD(CTD group) and 30 patients with CTD-ILD(CTD-ILD group) in Shenzhen Hospital, Southern Medical University from January 2019 to December 2021 were analyzed retrospectively. Clinical symptoms of CTD-ILD and CTD patients, high-resolution CT scanning(HRCT), cytokine(IL-6, TNF-α and IFN-γ) detection results and lung function examination results were collected. The serum samples of 30 healthy adults were collected as the normal control group, and the levels of cytokines(IL-6, TNF-α and IFN-γ) were detected. Result: The levels of IL-6, TNF-α and IFN-γ in peripheral serum of CTD-ILD group and CTD group were higher than those of the normal control group(P<0.05);the levels of IL-6 and TNF-α in CTD-ILD group were higher than those in CTD group(P<0.05), but there was no significant difference in IFN-γ between CTD-ILD group and CTD group(P>0.05). There were no significant differences in serum levels of IL-6, TNF-α and IFN-γ among different primary disease types in CTD-ILD group(P>0.05). The levels of IL-6 and TNF-α in peripheral serum of CTD-ILD patients were negatively correlated with FEV1%pred and DLCO%pred(P<0.05). Conclusion: Detection of IL-6 and TNF-α levels is helpful to understand the severity of alveolar inflammation in CTD-ILD patients, and IL-6 and TNF-α are closely related to lung function,which has important clinical guiding significance for the diagnosis and prediction of the disease of CTD-ILD.