结核病患者细胞因子表达水平影响因素分析

Analysis of Influencing Factors of Cytokine Expression Level in Tuberculosis Patients

目的 比较结核病患者与健康人群细胞因子水平差异,探讨结核病患者细胞因子水平影响因素。方法 收集2019年6月至2020年1月来郑州市第六人民医院就诊的81例结核病患者及50例健康体检者的12项细胞因子[干扰素-γ(IFN-γ)、白细胞介素-5(IL-5)、白细胞介素-2(IL-2)、白细胞介素-6(IL-6)、白细胞介素-1β(IL-1β)、白细胞介素-10(IL-10)、白细胞介素-8(IL-8)、白细胞介素-17(IL-17)、白细胞介素-4(IL-4)、白细胞介素-12P70(IL-12P70)、肿瘤坏死因子-α(TNF-α)、干扰素-α(IFN-α)]检测数据。对两组人群的各项细胞因子水平进行独立样本t检验,比较差异。对可能影响结核病患者细胞因子水平的影响因素,年龄、抗结核治疗周期、不良反应等进行单因素方差分析;对性别、合并症、临床症状等因素的12项细胞因子进行独立样本t检验。结果 结核病患者细胞因子IL-5、IL-2、IL-1β、IL-17、IL-4、IL-12P70、TNF-α表达水平均低于健康体检者,差异有统计学意义(P=0.005、P=0.010、P<0.001、P=0.029、P<0.001、P=0.031、P=0.005)。结核病患者不同性别、是否合并糖尿病、治疗过程是否有不良反应对12项细胞因子的表达无影响,差异无统计学意义(P>0.05)。结核病患者的细胞因子IL-5、IL-6在不同年龄段的表达水平不同,差异有统计学意义(P<0.05);IL-6、IL-10、TNF-α在不同抗结核治疗时间周期的表达水平不同,差异有统计学意义(P<0.05);是否合并肝炎对细胞因子IL-17表达水平有影响,差异有统计学意义(t=2.419,P=0.023);是否有发热症状对细胞因子IL-1β表达水平有影响,差异有统计学意义(t=-2.208,P=0.030);是否有体重减轻症状对细胞因子IL-12P70表达水平有影响,差异有统计学意义(t=-2.278,P=0.026)。结论 结核病患者与健康人群的细胞因子表达水平有差异。年龄和抗结核治疗周期、是否合并肝炎、是否有发热症状、是否伴随体重减轻可能是影响结核病患者细胞因子表达水平的因素之一。

Objective To compare the differences in cytokine levels between tuberculosis patients and healthy people,and to investigate the influencing factors of cytokine levels in tuberculosis patients.Methods The detection data of twelve cytokines[interferon-γ(IFN-γ),interleukin-5(IL-5),interleukin-2(IL-2),interleukin-6(IL-6),interleukin-1β(IL-1β),interleukin-10(IL-10),interleukin-8(IL-8),interleukin-17(IL-17),interleukin-4(IL-4),Interleukin-12P70(IL-12P70),tumor necrosis factor-α(TNF-α)and interferon-α(IFN-α)]from tuberculosis patients and healthy people who visited Zhengzhou Sixth People's Hospital from June 2019 to January 2020 were collected,including 81 tuberculosis patients and 50 healthy people.Independent sample t-tests were performed on the cytokine levels of the two groups to compare the differences.Univariate ANOVA was performed on the influencing factors that may affect cytokine levels in tuberculosis patients:age,anti-tuberculosis treatment cycle,adverse reactions,etc.Independent sample t-tests were performed for gender,comorbidities,clinical symptoms and other factors.Results The expression levels of cytokines IL-5,IL-2,IL-1β,IL-17,IL-4,IL-12P70 and TNF-αin tuberculosis patients were lower than those in healthy people,and the differences were statistically significant(P=0.005,P=0.010,P<0.001,P=0.029,P<0.001,P=0.031,P=0.005).There were no significant differences in the expression of these 12 cytokines in tuberculosis patients of different sexes,whether diabetes mellitus was combined,and whether there were adverse reactions during treatment(P>0.05).There were statistically significant differences in the expression levels of IL-5 and IL-6 in different ages in tuberculosis patients(P<0.05),and there were statistically significant differences in the expression levels of IL-6,IL-10 and TNF-αin different anti-tuberculosis treatment time periods in tuberculosis patients(P<0.05).The presence or absence of hepatitis in tuberculosis patients had a statistically significant difference in cytokine IL-17 expression level(t=2.419,P=0.023).The presence of fever affected the expression level of cytokine IL-1β,with significant difference(t=-2.208,P=0.030);The presence of weight loss affected the expression level of cytokine IL-12P70,with significant difference(t=-2.278,P=0.026).Conclusion There are differences in cytokine expression levels between tuberculosis patients and healthy people.Age and anti-tuberculosis treatment cycle,whether hepatitis is complicated,whether there are fever symptoms,and whether it is accompanied by weight loss may be one of the factors affecting the expression level of cytokines in tuberculosis patients.