外周血免疫功能指标及IL-2、IL-6、TNF-α对急、慢性期布鲁氏菌病感染的诊断价值

Diagnostic value of peripheral blood immune function indicators,IL-2,IL-6 and TNF-αfor acute and chronic brucellosis

目的分析外周血免疫功能指标及白细胞介素(IL)-2、IL-6、肿瘤坏死因子-α(TNF-α)对急、慢性期布鲁氏菌病感染的诊断价值。方法选取布鲁氏菌病感染者86例(急性组、慢性组)及健康体检者50名(对照组),比较其外周血T淋巴细胞亚群、免疫球蛋白、细胞因子,分析感染者治疗前后、不同疾病特征上述指标,各指标诊断价值。结果急性组、慢性组CD_(8)^(+)、免疫球蛋白(Ig)G、IgA、IgM、IL-4、IL-10、IL-6较对照组高,CD_(4)^(+)、CD_(4)^(+)/CD_(8)^(+)、干扰素-γ(IFN-γ)、IL-2、TNF-α较对照组低(P<0.05),急性组CD_(4)^(+)、CD_(8)^(+)、IgG、IgA、IL-4、IL-6较慢性组高,而IFN-γ、IL-2、TNF-α较慢性组低(P<0.05);治疗后布鲁氏菌病感染者IFN-γ、IL-2、TNF-α增加,其他指标降低,急性组治疗后CD_(4)^(+)、CD_(4)^(+)/CD_(8)^(+)、IgG、IgA、IL-6低于慢性组,CD_(8)^(+)、IL-2、TNF-α高于慢性组(P<0.05);CD_(4)^(+)、CD_(8)^(+)、IgG、IgA、IFN-γ、IL-2、IL-6、TNF-α预测急性期布鲁氏菌病的曲线下面积为0.787、0.736、0.685、0.742、0.749、0.758、0.603、0.642。结论外周血免疫功能指标及细胞因子对急、慢性期布鲁氏菌病感染有一定诊断价值,可加以监测。

OBJECTIVE To analyze the diagnostic value of peripheral blood immune function indicators,interleukin-2(IL-2),interleukin-6(IL-6)and tumour necrosis factor-alpha(TNF-α)for acute and chronic brucellosis.METHODS A total of 86 patients with brucellosis(acute group and chronic group)and 50 healthy volunteers(control group)were included in this study.Peripheral blood T lymphocyte subsets,immunoglobulins and cytokines were compared between the groups.These indicators in the infected patients before and after treatment,and in patients with different disease characteristics were comparatively analyzed.The diagnostic value of the indicators was analyzed.RESULTS The levels of CD_(8)^(+),IgG,IgA,IgM,IL-4,IL-10 and IL-6 in the acute group and the chronic group were higher than those in the control group,and the levels of CD_(4)^(+),CD_(4)^(+)/CD_(8)^(+),IFN-γ,IL-2 and TNF-αwere lower than those in the control group(P<0.05).The levels of CD_(4)^(+),CD_(8)^(+),IgG,IgA,IL-4 and IL-6 in the acute group were higher than those in the chronic group,and the levels of IFN-γ,IL-2 and TNF-αwere lower than those in the chronic group(P<0.05).After treatment,the levels of IFN-γ,IL-2 and TNF-αincreased,while the other indicators decreased in patients with brucellosis.After treatment,the levels of CD_(4)^(+),CD_(4)^(+)/CD_(8)^(+),IgG,IgA and IL-6 in the acute group were lower than those in the chronic group,while the levels of CD_(8)^(+),IL-2 and TNF-αwere higher than those in the chronic group(P<0.05).The areas under the ROC curve of CD_(4)^(+),CD_(8)^(+),IgG,IgA,IFN-γ,IL-2,IL-6 and TNF-αfor predicting acute brucellosis were 0.787,0.736,0.685,0.742,0.749,0.758,0.603 and 0.642,respectively.CONCLUSION Peripheral blood immune function indicators and cytokines are helpful for diagnosing acute and chronic brucellosis.