肺结核患者血清中免疫抑制酸性蛋白变化及其临床意义

目的　探讨肺结核患者血清中免疫抑制酸性蛋白 (IAP)变化及临床应用价值。方法　采用琼脂扩散法检测 336例肺结核患者及对照组血清中免疫抑制酸性蛋白水平。结果　肺结核、健康、非结核呼吸道疾病组血清中IAP分别为 (797± 16 8)、(36 7± 71)、(4 0 4± 75 )mg/L。如果将免疫功能受抑制的阳性界值定在 >5 0 0mg/L ,则 3组的阳性率分别为 96 7%、9 2 %、9 6 % (P <0 0 5 ) ,原发型肺结核、血行播散型肺结核、浸润型肺结核、慢性纤维空洞型肺结核、结核性胸膜炎患者阳性率分别为10 0 0 %、10 0 0 %、96 0 %、98 6 %、96 9%。病情进展期肺结核患者IAP水平明显高于稳定期 ,治疗后病情好转者IAP逐逝下降。结论　测定肺结核患者血清中IAP能较直观反映其免疫抑制状况及病情严重程度 ,并对观察疗效、评判预后具有较好意义。

Change of immunosuppressive acidic protein in sera of patients with pulmonary tuberculosis and its clinical significance

OBJECTIVE: To investigate the change of immunosuppressive acidic protein (IAP) in sera of patients with pulmonary tuberculosis (TB) and its clinical value. METHOD: IAP in sera of 336 patients suffering from pulmonary TB and controls was detected by agar diffusion assay. RESULTS: In pulmonary TB, healthy controls and non-TB respiratory diseases, the level of IAP was (797 +/- 168) mg/L, (367 +/- 71) mg/L and (404 +/- 75) mg/L, respectively. If > 500 mg/L was regarded as positive threshold, the positive rates in the above groups were 96.7%, 9.2% and 9.6%, respectively. IAP positive rates in cases of primary, disseminated, infiltrative, chronic fibro-cavernous pulmonary TB and tuberculous pleuritis were 100, 0%, 100.0%, 96.0%, 98.6% and 96.9%, respectively. IAP was significantly higher in progressive pulmonary TB than in stable pulmonary TB, and was decreased when patients' condition improved after treatment. CONCLUSION: Detection of IAP in sera of patients with pulmonary TB can reflect patients' immunosuppression status and the severity of the disease, and may be useful in assessing treatment effect and evaluating prognosis.