初治涂阳肺结核患者细胞因子变化及生命质量分析  

Quality of life and changes in cytokine factors among initial smear-positive pulmonary tuberculosis patients

作　　者：杨朝晖[1] 刘东红[1] 翁明钢 俞逊婕 沈杨[1] 方年 

机构地区：[1]台州市第一人民医院感染科,浙江318020

出　　处：《中国公共卫生》2016年第2期230-234,共5页Chinese Journal of Public Health

基　　金：台州市科学技术资助项目(121ky10)

摘　　要：目的了解初治涂阳肺结核患者的细胞因子变化和生命质量情况,分析其影响因素,为确定肺结核综合防治方案提供参考依据。方法整群抽取浙江省台州市第一人民医院和温岭市结核病防治所2012年6月—2014年5月收治的196例初治涂阳肺结核患者,检测抗结核治疗前和治疗后2个月干扰素γ、白介素2、白介素10和白介素18的水平,同时应用中文版健康调查简表(SF-36)评价其生命质量情况,并分析生命质量的影响因素。结果肺结核患者治疗2个月后干扰素γ和白介素2水平分别为(97.3±40.5)和(54.1±19.3)ng/L,均高于治疗前的(43.2±17.3)和(36.3±13.9)ng/L,白介素10和白介素18水平分别为(82.3±29.4)和(130.9±50.3)ng/L,均低于治疗前的(116.2±44.7)和(243.0±86.8)ng/L(均P<0.05);治疗2个月后痰菌转阴患者的干扰素γ和白介素2水平分别为(109.8±35.4)和(58.1±18.7)ng/L,均高于痰菌未转阴患者的(50.4±16.3)和(39.0±13.3)ng/L,白介素10和白介素18水平分别为(77.3±24.2)和(107.6±33.6)ng/L,均低于痰菌未转阴患者的(102.4±32.9)和(221.3±69.2)ng/L(均P<0.05);肺结核患者SF-36量表生理功能、生理职能、躯体疼痛、总体健康、活力、社会功能、情感职能、精神健康维度得分和生命质量总分分别为(70.14±23.07)、(45.32±21.69)、(67.42±18.26)、(61.28±26.34)、(49.32±16.85)、(57.64±12.46)、(64.71±11.31)、(52.83±20.47)和(512.25±132.57)分;多因素非条件logistic回归分析结果显示,年龄>50岁、职业为农民、有债务负担和患慢性病的初治涂阳肺结核患者生命质量较低,文化程度初中及以上、年人均收入≥20 000元、有医保、治疗2个月后痰菌转阴和治疗3个月后病灶吸收的初治涂阳肺结核患者生命质量较高。结论初治涂阳肺结核患者抗结核治疗后细胞因子水平增高,但生命质量较低;年龄、文化程度、职业、年人均收入、有无医保、有无债务负担、是否患慢性病、治疗Objective To evaluate changes in cytokine factors and quality of life（ QOL） in patients with initial smear-positive pulmonary tuberculosis and to explore its main influencing factors,and to provide references for comprehensive prevention and treatment of tuberculosis. Methods Via cluster sampling,196 initial smear-positive pulmonary tuberculosis patients were recruited from Taizhou First People＇s Hospital and Wenling Tubertulosis Prevention Institution from June 2012 through May 2014. The levels of interferon gamma（ INF-γ）,interleukin-2（ IL-2）,interleukin-10（ IL-10）and interleukin-18（ IL-18） were determined at the day before and 2 months after the medication. The 36-Item Short Form Health Survey（ SF-36） was used to evaluate QOL among the patients. The influencing factors for QOL were evaluated by using univariate and multivariate non-conditional logistic regression analysis. Results The levels of INF-γ and IL-2 twomonth after the medication were 97. 3 ± 40. 5 and 54. 1 ± 19. 3 ng / L,higher than 43. 2 ± 17. 3 and 36. 3 ± 13. 9 ng / L before the medication（ both P〈0. 05）. The levels of IL-10 and IL-18 two-month after the medication were 82. 3 ± 29. 4 and130. 9 ± 50. 3 ng / L,lower than 116. 2 ± 44. 7 and 243. 0 ± 86. 8 ng / L before the medication（ both P〈0. 05）. Two months after the medication,the levels of INF-γ and IL-2 in the patients with sputum smear-negative conversion were109. 8 ± 35. 4 and 58. 1 ± 18. 7 ng / L,higher than 50. 4 ± 16. 3 and 39. 0 ± 13. 3 ng / L in the patients without the conversion（ both P〈0. 05） and the levels of IL-10 and IL-18 in patients without sputum smear-negative conversion were 77. 3 ±24. 2 and 107. 6 ± 33. 6 ng / L,lower than 102. 4 ± 32. 9 and 221. 3 ± 69. 2 ng / L in the patients with the conversion（ both P〈0. 05）. The QOL domain scores were 70. 14 ± 23. 07 for physiological function,45. 32 ± 21. 69 for role-physical,67. 42 ± 18. 26 for bodily pain,61. 28 ± 26. 34 for general health,49. 32 ± 16. 85 for v

关 键 词：细胞因子 变化 生命质量 影响因素 初治涂阳肺结核患者 

分 类 号：R521[医药卫生—内科学]