慢性阻塞性肺疾病急性加重期合并肺结核患者外周血清中IL-6、TNF-α和IFN-γ水平变化及临床意义

目的 探究慢性阻塞性肺疾病急性加重期(AECOPD)合并肺结核患者外周血清中IL-6、肿瘤坏死因子α(TNF-α)和干扰素γ(IFN-γ)水平变化及临床意义.方法 将研究对象分为AECOPD合并肺结核组、AECOPD组、肺结核组和健康对照组,根据肺结核患者影像学检查结果将肺结核患者分为单侧病变组、双侧病变组、无空洞组和有空洞组,根据AECOPD合并肺结核患者治疗后的情况分为好转组和恶化组.采用ELISA法检测各组患者血清中的IL-6、TNF-α和IFN-γ水平.结果 AECOPD合并肺结核组血清中的IL-6和TNF-α水平显著高于AECOPD组和肺结核组(P＜0.05);单侧病变组患者血清中的IL-6、TNF-α和IFN-γ的水平显著低于双侧病变组(P＜0.05);无空洞组患者血清中的IL-6、TNF-α和IFN-γ的水平显著低于有空洞组(P＜0.05);病情好转组治疗后IL-6、TNF-α和IFN-γ水平显著低于治疗前(P＜0.05).结论 IL-6、TNF-α和IFN-γ在AECOPD合并肺结核的发病机制中起着一定的作用,其外周血清中水平的动态变化在一定程度上可以反映AECOPD合并肺结核病情的发展与转归.

Clinical significance and diversification of IL-6, TNF-α and IFN-γ in serum of AECOPD patients with pulmonary tuberculosis

Objective To explore clinical significance and diversification of interleukin-6 (IL-6),tumor necrosis factor-α (TNF-α) and interferon-γ (IFN-γ) in serum of acute exacerbation of chronic obstructive pulmonary disease (AECOPD) patients with pulmonary tuberculosis.Methods The study subjects were divided into AECOPD with pulmonary tuberculosis group,AECOPD group,pulmonary tuberculosis group and healthy control group.According to imaging findings in patients with pulmonary tuberculosis,patients were divided into unilateral lesion group,bilateral lesion group,free cavity group and cavity group.According to the situation of AECOPD with pulmonary tuberculosis,patients were divided into improved group and deterioration group after treatment.IL-6,TNF-α and IFN-γ levels in serum of each group were detected by ELISA method.Results IL-6 and TNF-α levels in serum of AECOPD with pulmonary tuberculosis group were significantly higher than AECOPD group and tuberculosis group (P ＜ 0.05).IL-6,TNF-α and IFN-γ levels in patients with unilateral lesion group were significantly lower than bilateral lesion group (P ＜0.05).IL-6,TNF-α and IFN-γ levels in patients with free cavity group were significantly lower than cavity group (P ＜ 0.05).IL-6,TNF-α and IFN-γ levels after treatment in improved group were significantly lower than that before treatment (P ＜ 0.05).Conclusions IL-6,TNF-α and IFN-γ play a role in the pathogenesis of AECOPD with pulmonary tuberculosis.The dynamic changes of the serum level can reflect the development and prognosis of AECOPD with pulmonary tuberculosis in a certain degree.