肺结核患者中性粒细胞防御素1-3表达的临床研究

目的探讨人中性粒细胞防御素1-3(HNP1-3)在肺结核及耐多药肺结核发生中的作用。方法采用ELISA法检测正常人(对照组)、对药物敏感(敏感组)与耐多药(耐多药/多耐药组)肺结核患者血浆HNP1-3的浓度,并观察敏感组和耐多药/多耐药组抗结核治疗6个月后HNP1-3的变化。结果治疗前血浆HNP1-3浓度:对照组、敏感组、耐多药/多耐药组分别为(87.6±8.7)、(141.7±21.3)(、41.0±10.9)ng/ml,敏感组>对照组>耐多药/多耐药组(P分别<0.05)。抗结核治疗6个月后血浆HNP1-3浓度:敏感组为(76.5±7.1)ng/ml,较治疗前明显下降(p<0.01),耐多药/多耐药组为(53.2±7.1)ng/ml,与治疗前相比无差异(p>0.05)。血浆HNP1-3浓度与痰菌阳性持续时间及X线胸片记分呈负相关(r分别为-0.635,-0.465,p<0.01)、与外周血白细胞及中性粒细胞计数呈正相关(r分别为0.594,0.728,p<0.01)。结论HNP1-3在肺结核及耐多药肺结核的发生中可能起一定作用,HNP1-3水平降低可能是耐多药肺结核形成的原因之一。

Clinical study of plasma human neutrophil peptides1-3 in patients with pulmonary tuberculosis

Objective To investigate the role of human neutrophil peptides1-3(HNP1-3) in patients with pulmonary tuberculosis(PTB) and multidrug-resistant pulmonary tuberculosis(MDR-PTB). Methods Concentrations of HNP1-3 in plasma were measured by ELISA in control group(20 healthy subjects),sensitive group(21 patients with drug-sensitive cases) and MDR group(21 patients with multidrug-resistant pulmonary tuberculosis).We also detected the change of plasma HNP1-3 in patients with tuberculosis both sensitive and MDR after treated with anti-tuberculosis-drugs for six months. Results Before treatment,mean plasma concentrations of HNP1-3 in control group,sensitive group and MDR group were 87.6±8.7,141.7±21.3 and 41.0±10.9 ng/mL respectively.Plasma concentrations of HNP1-3 in sensitive group were much higher than control group(p<0.05).Control group’s were higher than MDR group (p<0.05).After treatment,Mean plasma concentrations of HNP1-3 in sensitive group and MDR group were 76.5±7.1 and 53.2±7.1 ng/mL respectively.Plasma HNP1-3 in sensitive group was decreased compared with before treatment(p<0.01).But there was no difference in MDR group before and after treatment(p>0.05).There was a negative relationship between plasma HNP1-3 before treatment and persistence time of mycobacterium tuberculosis in sputum(r=-0.635,p<0.01),and between the radiographic score before treatment(r=-0.465,p<0.01).Plasma concentrations of HNP1-3 in all investigated subjects correlated positively with their count of peripheral blood leucocyte and neutrophil(r=0.594,0.728,p<0.01). Conclusion HNP1-3 plays important role in pathogenesis of pulmonary tuberculosis and MDR pulmonary tuberculosis.The decreased of plasma HNP1-3 may be one of major reasons in the formation of MDR-PTB.