肺结核患者支气管肺泡灌洗液细胞因子的水平及其动态变化  

Dynamic changes of some cytokines in bronchoalveolar lavage fluid in patients with pulmonary tuberculosis

作　　者：曾谊[1] 王新宁[1] 宋梅梅[1] 何花[1] 林云霞[1] 

机构地区：[1]南京市胸科医院结核科,江苏南京210029

出　　处：《临床肺科杂志》2015年第7期1231-1234,共4页Journal of Clinical Pulmonary Medicine

基　　金：南京市医学科学发展项目(No YKK11061)

摘　　要：目的研究肺结核患者支气管肺泡灌洗液(BALF)中γ干扰素(IFN-γ)、白细胞介素12(IL-12)、白细胞介素4(IL-4)、白细胞介素10(IL-10)水平的变化及其临床意义。方法采用双抗体夹心ELISA法检测60例活动性肺结核患者、33例非活动性肺结核患者BALF中IFN-γ、IL-12、IL-4、IL-10的水平,对其中32例活动性肺结核患者抗结核治疗后的上述细胞因子水平进行随访。组间比较采用t检验。结果活动性肺结核病例BALF中IFN-γ、IL-12的水平要显著高于非活动性肺结核病例(P<0.01),而IL-4、IL-10的水平两组间无明显差异(P>0.05)。菌阳及重症肺结核的IFN-γ、IL-4、IL-12水平要明显高于菌阴及轻症(P<0.05),IL-10值无明显差异(P>0.05)。32例活动性肺结核的病例在抗痨治疗一个月后复查支气管镜,BALF中IFN-γ、IL-4、IL-12的水平均较治疗前有明显的下降(P<0.01)。而IL-10值亦有所下降,但差异无统计学意义(P>0.05)。结论肺结核患者BALF中IFN-γ、IL-4、IL-12水平的检测可作为了解病灶活动性、严重程度、监测疗效的参考。Objective To investigate the characteristics and its clinical value of IFN-γ, IL-12, IL-4 and IL-10 in bronchoalveolar lavage fluid （ BAIF） in patients with pulmonary tuberculosis. Methods The concentrations of IFN-γ, IL-12, IL-4 and IL-10 were measured by ELISA method in BAIF of 60 patients with active tuberculosis and 33 patients with inactive tuberculosis. Meanwhile, the above-mentioned cytokine levels in BALF of 32 patients with active tuberculosis were followed up. Differences between the two groups were assessed by t test. Results The levels of IFN-γand IL-12 in BAIF were significantly higher in the active tuberculosis group than in the inactive tuberculosis group （P〈0. 01）, and the levels of IL-4 and IL-10 showed no significant difference between the two groups （P〉0. 05 ） . The levels of IFN-γ, IL-4 and IL-12 in BALF of the smear-positive and severe pulmonary tuberculosis groups were all significantly higher than those of the smear-negative and mild tuberculosis groups （P〈0. 01）. 1 month after anti-tuberculosis treatments, the levels of IFN-γ, IL-4 and IL-12 in BALF decreased significantly in 32 cases of ac-tive tuberculosis （P〈0. 01）. Conclusion The detection of IFN-γ, IL-4 and IL-12 in BALF is helpful to under-stand the activity and the severity of disease and monitor the therapeutic effect in patients with pulmonary tuberculo-sis.

关 键 词：结核 肺IFN-γ IL-4 IL-12 支气管肺泡灌洗液 

分 类 号：R521[医药卫生—内科学]