肺结核患者血清TNF-α、瘦素、脂联素检测的研究  

Investigation of Serum TNF-α,Leptin and Adiponectin Levels in Patients With Pulmonary Tuberculosis

作　　者：许忆新[1] 李爱美[1] 黄干[2] 

机构地区：[1]长沙市中心医院,湖南长沙410014 [2]中南大学湘雅二医院代谢内分泌研究所

出　　处：《实用预防医学》2007年第3期690-692,共3页Practical Preventive Medicine

摘　　要：目的研究肺结核患者血清中肿瘤坏死因子(TNF-α)、瘦素、脂联素水平,为进一步阐明肺结核病的病理过程提供依据。方法按照年龄、性别、体重指数相匹配的原则,选择53例活动性结核患者,49例静止期患者以及50例健康对照进行分组,检测其空腹静脉血清的TNF-α、瘦素、脂联素水平,并进行比较与分析。结果三组之间在平均年龄、性别比例、体重指数(BMI)等方面差异无显著性(P>0.05);活动性肺结核组和静止期组血清中TNF-α水平均高于健康对照组(27.9±5.2ng/L和18.2±5.7ng/Lvs11.7±3.2ng/L,P分别<0.001和<0.01),且活动性肺结核组高于静止期组(P<0.01)。活动性肺结核组和静止期组血清中脂联素水平均低于健康对照组(3.27±1.52mg/L和6.12±1.93mg/Lvs9.93±2.25mg/L,P分别<0.001和<0.01),且活动性肺结核组低于静止期组(P<0.01)。三组间血清瘦素水平差异无显著性(P>0.05);在静止期组和活动性肺结核组中,血清脂联素水平与TNF-α均呈负相关(r分别为-0.602和-0.698,P均<0.001),与体重指数也均呈负相关(r分别为-0.642和-0.671,P均<0.001)。血清瘦素水平与体重指数呈正相关,但与TNF-α以及脂联素水平无相关性(P>0.05)。结论TNF-α和脂联素参与了肺结核病的免疫炎症应答反应,并与疾病的进程相关。而瘦素并非肺结核免疫反应的产物,与疾病的进程无关,体重指数是影响瘦素分泌的重要因素。Objective To investigate the serum TNF- α, leptin and adiponectin levels in patients with pulmonary tuberculosis, and to provide scientific evidences for further clarifying pathological process of tuberculosis. Methods Fasting serum TNF-α, leptin and adiponectin levels were detected in .53 active tuberculosis patients （active TB group）, 49 resting period tuberculosis patients （resting period TB group） and .50 healthy controls （control group）, which matched with age, sex and BMI. The detection data of these three groups were compared and analyzed. Results Patients in three groups were matched in age, sex and BMI and showed no significant difference（P〉0,05）. Serum TNF - α levels in both active and resting period TB groups were higher than those in control group（27.9 ± 5,2 ng/L and 18.2 ± .5.7 ng/L vs 11.7 ± 3.2 ng/L; P〈 0. 001 and P〈0.01）, and also, TNF-α levels in active TB patients were higher than those of resting period patients（P〈 0.01）. The serum adiponectin levels in both active and resting period TB groups were lower than those in control group（3.27 ± 1.52 rngJL and 6.12± 1.93mg/L vs 9.93 ± 2.25mg/L; P〈0.001 and P〈0.01）, and again the adiponectin levels in active TB patients were lower than those of resting period patients（P〈0.01）. The serum leptin levels in all the three groups showed no statistical significant difference （P〉0.05）. In patients with active and resting period TB, adiponectin levels were negatively correlated with TNF - α（r = - 0.602 and - 0. 698, P〈 0,001） and BMI （r = - 0. 642 and - 0. 671, P〈 0. 001）, The leptin levels were positively correlated with BMI, but not significantly correlated with TNF - α and adiponectin（P〉0.05）. Conclusion TNF -α and adiponectin are associated with the immune - inflammatory response of pulmonary tuberculosis and disease activity, while leptin has no relation to the disease activity,and BMI plays an important role in the secretion of leptin.

关 键 词：肺结核 肿瘤坏死因子 瘦素 脂联素 

分 类 号：R52[医药卫生—内科学]