抗结核治疗前后的细胞因子水平变化分析

目的 分析抗结核治疗前后敏感肺结核与耐药肺结核患者的细胞因子水平的变化。方法 收集2019年8月—2020年10月新疆医科大学第八附属医院收治的213例肺结核患者的临床资料，分为敏感肺结核组和耐药肺结核组，其中敏感组141例，耐药组72例，比较治疗前、治疗3个月及6个月血浆中促炎因子肿瘤坏死因子-α(TNF-α)、IL-6、IL-17、干扰素-γ(IFN-γ)及抗炎因子IL-10、IL-4的含量变化情况。结果 与健康组相比，敏感组及耐药组血浆IL-6含量升高明显，差异有统计学意义（P<0.01），敏感组血浆IFN-γ、IL-17含量升高，差异有统计学意义（P<0.05）。与治疗前相比，敏感组治疗6个月比治疗3个月血浆中IL-6、IL-4含量降低，差异有统计学意义（P<0.05）,IFN-γ降低明显（P<0.001）；治疗6个月比治疗前IL-10含量降低，差异有统计学意义（P<0.05）,IFN-γ降低明显（P<0.000 1）；耐药组均无明显变化；敏感组治疗前及治疗3个月IFN-γ均高于耐药组，差异有统计学意义（P<0.01），治疗6个月后敏感...

Changes of cytokine levels before and after anti-tuberculosis treatment

Objective To analyze the changes of cytokine levels in patients with sensitive pulmonary tuberculosis and drug-resistant pulmonary tuberculosis before and after anti-tuberculosis treatment. Methods The clinical data of 213 pulmonary tuberculosis patients admitted to the Eighth Affiliated Hospital of Xinjiang Medical University from August 2019 to October 2020 were collected, and divided into a sensitive pulmonary tuberculosis group and a drug-resistant pulmonary tuberculosis group, of which 141 were in the sensitive group and 72 in the drug-resistant group , and the pro-inflammatory factors tumor necrosis factor-α (TNF-α), IL-6, IL-17, interferon-γ (IFN-γ) and anti-inflammatory factors IL-10 and IL-4 in plasma before treatment, 3 months and 6 months after treatment were compared. Results Compared with the healthy group, the levels of plasma IL-6 in the sensitive group and the resistant group were significantly increased, difference was statistically significant (P<0.01). The plasma levels of IFN-γ and IL-17 in the sensitive group were increased, and the difference was statistically significant (P<0.05). Compared with before treatment, the levels of IL-6 and IL-4 in the plasma of the sensitive group after 6 months of treatment were lower than those after 3 months of treatment, and the difference was statistically significant (P<0.05), and IFN-γ was significantly decreased (P<0.001). After 6 months of treatment, the IL-10 content was lower than that before treatment, and the difference was statistically significant (P<0.05), and the IFN-γ decreased significantly (P<0.000 1). The levels of IFN-γ at 3 months were higher than those in the resistant group, and the difference was statistically significant (P<0.01). After 6 months of treatment, there was no significant difference in the content of IFN-γ between the sensitive group and the resistant group. The effective rate of CT absorption was 70% in the sensitive group and only 43.33% in the resistant group at 3 months of treatment, and there was no significant difference in the effective rate between the two groups after 6 months of treatment. Conclusions Detection of pro-inflammatory cytokines and anti-inflammatory cytokines in plasma can provide reference for host-directed therapy of pulmonary tuberculosis. Understanding this important feature of cytokines on pathogen-host interactions can provide new insights into the study of virulence mechanisms and may provide new approaches for immune intervention in pulmonary tuberculosis.