IFN-γ及血清炎症因子水平变化与肺结核发病相关性及作用机制分析

Correlation between IFN-γ,serum inflammatory factors and pathogenesis of tuberculosis and action mechanisms

目的 研究干扰素-γ(IFN-γ)及血清炎症因子水平变化与肺结核发病相关性及作用机制。方法 选取2014年9月-2017年6月72例肺结核感染患者为研究组,同期51例健康体检人群为对照组。观察和比较治疗前后肺结核感染患者和健康人群血清炎症因子白介素-6(IL-6)、白介素-10(IL-10)、肿瘤坏死因子-α(TNF-α)、IFN-γ水平。分析血清IFN-γ及炎症因子水平变化与肺结核发病相关性。结果 研究组患者治疗后血清IFN-γ水平较治疗前升高,IL-6、IL-10、TNF-α水平较治疗前均下降,差异均有统计学意义(P<0.05)。且治疗后与对照组比较,差异无统计学意义;ROC曲线显示,IFN-γ、IL-6敏感性优于IL-10、TNF-α,其中IFN-γ特异性最高;IFN-γ与IL-6、IL-10、TNF-α呈负相关性(P<0.05)。结论 血清IFN-γ、炎症细胞因子参与了肺结核感染发病及进展过程,为肺结核感染免疫研究提供了有力证据。且通过外源性IFN-γ,有助于调节Th1/Th2动态平衡,促进肺结核感染患者体内Th2优势向Th1优势转换,为临床防治肺结核感染提供了一种有别于传统抗结核治疗的新思路。

OBJECTIVE To observe the correlation between the changes of levels of interferon-γ(IFN-γ)and serum inflammatory factors and the pathogenesis of tuberculosis and analyze the action mechanisms.METHODS Totally 72patients with pulmonary tuberculosis who were treated from Sep 2014to Jun 2017were assigned as the study group,meanwhile,51healthy people who received physical examination were set as the control group.The levels of serum inflammatory factors interleukin-6(IL-6),interleukin-10(IL-10),tumor necrosis factor-α(TNF-α)and IFN-γwere observed and compared between the patients with pulmonary tuberculosis and the healthy people before and after the treatment.The correlation between the changes of serum IFN-γand inflammatory factors and the pathogenesis of tuberculosis was analyzed.RESULTS The serum IFN-γlevel of the study group was significantly higher after the treatment than before the treatment,while the levels of IL-6,IL-10and TNF-αwere significantly lower after the treatment than before the treatment(P<0.05);there were no significant differences in the above indexes between the study group and the control group after the treatment.ROC curve analysis showed that the sensitivity of IFN-γand IL-6was significantly higher than that of IL-10and TNF-α,and the specificity of IFN-γ was highest;IFN-γwas negatively correlated with IL-6,IL-10and TNF-α(P<0.05).CONCLUSION The serum IFN-γand inflammatory cytokines involve in the pathogenesis and progression of pulmonary tuberculosis,which provide evidence for immunological study of pulmonary tuberculosis.The exogenous IFN-γmay facilitate the regulation of dynamic balance of Th1/Th2and promote the transition from Th2dominance to Th1dominance,which forges a new idea for clinical prevention and treatment of pulmonary tuberculosis that differentiate from the traditional anti-tuberculosis therapy.