γ干扰素和转化生长因子β水平与支气管结核治疗效果的关联性研究  

Study on the relationship between the efficacy of endobronchial tuberculosis and the level of interferon-γ and transforming growth factor-β

作　　者：梁莉[1] 乐军[1] 刘丽蓉[1] 沙巍[1] 方勇[1] 蒋瑞华[1] 唐神结[1] 肖和平[1] 

机构地区：[1]同济大学附属上海市肺科医院上海市结核(肺)重点实验室,200433

出　　处：《中国防痨杂志》2011年第11期703-706,共4页Chinese Journal of Antituberculosis

基　　金：上海市卫生局课题(2007111)

摘　　要：目的探讨血清和支气管灌洗液中γ干扰素(IFN-γ)和转化生长因子β(TGF-β)水平与支气管结核(EBTB)治疗效果之间的关联性。方法采用酶联免疫吸附(ELISA)方法测定78例EBTB患者支气管镜下介入治疗前后血清和支气管灌洗液中IFN-γ和TGF-β的水平,以及50名健康对照血清中IFN-γ和TGF-β的水平。EBTB患者被分成2组:一组治疗后表现为支气管狭窄,另一组治疗后未表现为支气管狭窄。结果研究显示:(1)与对照组相比,EBTB患者组支气管灌洗液中IFN-γ和TGF-β水平升高。(2)78例EBTB患者治疗后,27例患者显示有支气管的纤维狭窄,51例患者没有支气管狭窄。支气管狭窄组治疗前血清TGF-β水平[(783.21±478.67)pg/ml]比无支气管狭窄组[(1258.60±573.29)pg/ml]低(U=3.8905,P<0.01),而支气管灌洗液中TGF-β[(1219.54±439.27)pg/ml]和IFN-γ[(2152±1594.33)pg/ml]水平明显高于无狭窄组[(779.24±395.91)pg/ml,(1006.30±752.57)pg/ml](U值分别为4.3553和3.5315,P值均<0.01)。结论 (1)EBTB患者支气管灌洗液中IFN-γ和TGF-β水平升高可能与支气管结核发病机制有关。(2)初始血清TGF-β低水平和支气管灌洗液IFN-γ和TGF-β高水平与治疗后支气管纤维狭窄有关。Objective To investigate the correlation between the treatment outcome of endobronchial tuber- culosis （EBTB） and the levels of interferon-γ （IFN-γ） and transforming growth factor-β （TGF-β） in the serum and bronehoalveolar lavage fluid （BALF）. Methods The levels of IFN-γand TGF-βwere measured by the ELISA method in the serum and BALF among 78 patients with EBTB before and after treatment and 50 healthy control. 78 patients with EBTB and fifty healthy controls were enrolled. The EBTB patients were divided into Group 1 in which patients who exhibited bronchial stenosis after treatment and Group 2 who had no bronchial stenosis. Results （1） IFN-γ and TGF-β levels of the BALF in patients with EBTB were higher than those in the healthy controls. （2）Of the 78 patients with EBTB after treatment, 27 cases exhibited bronchial fibrostenosis and the other 51 cases had recovered without sequelae. The levels of IFN-γ [（2152±1594.33） pg/ml] and TGF-β [（1219. 54±439. 27 ）pg/ml] in the BALF of the EBTB patients with bronchial fibrostenosis were higher than the patients without bronchial fibrostenosis in which IFN-γ was [（1006.3±752. 57） pg/ml ]and TGF-β [（779. 24±395.91） pg/ml] （U=4. 3553, 3. 5315,respec- tively, all P〈0. 01）. The level of TGF-β [（783.21±478. 67） pg/ml] in the serum from the EBTB patients with bronchial fibrostenosis was lower than that of TGF-β [-（1258. 6±573.29） pg/ml] in the serum from EBTB patients without bronchial fibrostenosis （U= 3. 8905, P〈0. 01）. Conclusion （1） Elevated IFN-γ and TGF-β levels in the BALF of the EBTB patients may be related to the pathogenesis of EBTB. （2） Low level of TGF-β in serum and high levels of IFN-γ and TGF-β in the BALF are correlated with bronchial fibrostenosis in EBTB after treatment.

关 键 词：结核 支气管治疗 缩窄 病理性 干扰素Ⅱ型 转化生长因子Β 

分 类 号：R521.2[医药卫生—内科学]