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目的探讨肺结核患者体内结核病相关免疫细胞因子动态变化。方法选择本院2014年11月—2015年11月收治的活动性肺结核患者60例。给予所有患者化疗治疗,并检测治疗前后IFN-γ、IL-4、IL-17、TNF-α、TGF-β及IL-10水平情况。不同治疗时间细胞因子水平的比较采用重复测量资料的方差分析;计量资料两组间比较采用独立样本t检验,组内比较采用配对t检验;计数资料比较采用χ~2检验,P<0.05为差异有统计学意义。结果随着治疗时间的延长,患者的TGF-β、IL-4水平[(169.22±22.46)、(142.9±13.71)、(123.2±10.03)ng/L与(65.29±12.30)、(29.38±3.27)、(28.29±3.18)ng/L]逐渐降低,差异均有统计学意义(均P<0.05);不同治疗时间患者的IL-10、IL-17水平[(8.12±1.46)、(5.36±0.93)、(10.47±1.03)ng/L与(14.10±1.68)、(12.93±1.01)、(12.59±0.22)ng/L]比较,差异均有统计学意义(均P<0.05)。治疗6个月后两组患者的TGF-β、IL-10、IL-4水平[(115.8±49.2)、(163.7±20.4)ng/L与(12.8±2.4)、(5.4±1.2)ng/L与(24.5±15.3)、(66.3±25.3)ng/L]比较,差异均有统计学意义(均P<0.05)。结论肺结核体内免疫反应中不同细胞因子会呈现不同变化,TGF-β、IL-4水平会在肺结核活动期呈现高水平状况,在病情缓解后会显著下降。
Objective To investigate the dynamic changes of tuberculosis-associated immune cytokines in patients with pulmonary tuberculosis. Methods Sixty patients with active pulmonary tuberculosis admitted to our hospital from November 2014 to November 2015 were selected. All patients were given chemotherapy and the levels of IFN-γ, IL-4, IL-17, TNF-α, TGF-β and IL-10 were measured before and after treatment. The comparison of cytokine levels at different treatment time was made by repeated measures of ANOVA. The measurement data were compared by independent sample t-test and paired t-test. The count data were compared byχ ~ 2 test, P <0.05 was the difference There is statistical significance. Results With the prolongation of treatment time, the levels of TGF-β and IL-4 in the patients [(169.22 ± 22.46), (142.9 ± 13.71), (123.2 ± 10.03) ng / L and (65.29 ± 12.30), (29.38 ± 3.27 ), (28.29 ± 3.18) ng / L], the differences were statistically significant (all P <0.05). The levels of IL-10 and IL-17 in different treatment time were significantly higher than those in control group [(8.12 ± 1.46) and (P <0.05). There was significant difference between the two groups (P <0.05). The difference was statistically significant (P <0.05). The levels of TGF-β, IL-10 and IL-4 in the two groups after treatment for 6 months [(115.8 ± 49.2), (163.7 ± 20.4) ng / L vs (12.8 ± 2.4), (5.4 ± 1.2) L and (24.5 ± 15.3) and (66.3 ± 25.3) ng / L, respectively. There were significant differences between the two groups (all P <0.05). Conclusion Different cytokines in the immune response of tuberculosis will show different changes. The levels of TGF-β and IL-4 will show a high level in the active stage of tuberculosis and will be significantly reduced after the condition is relieved.