肺结核患者治疗中免疫球蛋白E及血清细胞因子检测的临床意义  

Clinical significance of Ig-E and serum cytokine levels in the treatment of patients with pulmonary tuberculosis

作　　者：张福红 魏铁垒 刘丽莹 王英 张小静 

机构地区：[1]许昌市人民医院呼吸内科,河南许昌461000 [2]许昌市人民医院急诊科,河南许昌461000

出　　处：《中华医院感染学杂志》2016年第16期3648-3650,共3页Chinese Journal of Nosocomiology

基　　金：河南省科技厅基金资助项目(2013048274K)

摘　　要：目的探讨抗肺结核治疗检测免疫球蛋白E(IgE)和血清细胞因子白细胞介素(IL)-6、IL-8、IL-10、肿瘤坏死因子-α(TNF-α)水平变化,在肺结核治疗中的价值,以寻找更直观反应病情变化的指标。方法选择医院2014年1月-2015年1月肺结核患者79例,随肺结核治疗情况分为A、B组,A组34例为初次患病进展期肺结核分枝杆菌感染患者,B组45例为经治疗后复发患者,两组患者均给予短程抗结核治疗,观察入院时、治疗3个月不同痰检结果,TNF-α、IL-6、IL-8、IL-10、IgE指标变化及治疗效果。结果 A组患者入院时IL-6、IL-8、IL-10指标水平均低于B组,差异有统计学意义(P<0.05),两组患者TNF-α、IgE组间对比,差异无统计学意义;经3个月治疗,A组痰检阴性18例、阳性13例、强阳性3例,B组阴性15例、阳性20例、强阳性10例;A组阳性、强阳性患者IL-6、IL-8与同组阴性患者同指标对比,差异无统计学意义,IL-10、TNF-α及IgE与同组阴性患者同指标对比,差异有统计学意义(P<0.05),TNF-α、IgE与B组同指标同痰检结果对比,差异有统计学意义(P<0.05);A组患者治疗总有效率为94.12%,B组患者为77.78%,两组总有效率对比,差异有统计学意义(P<0.05)。结论肺结核患者TNF-α、IgE水平对临床指导治疗及肺结核感染程度均具有重要价值。OBJECTIVE To investigate the value of immune globulin（Ig-E）and serum cytokine IL-6,IL-8,IL-10 and TNF-in the treatment of pulmonary tuberculosis,so as to find a more intuitive response to the changes in the condition of the disease.METHODS A total of 79 cases of patients with pulmonary tuberculosis from Jan.2014 to Jan.2015 were selected and divided into group A and B,along with the treatment of pulmonary tuberculosis.Group A was with 34 cases of primary disease progression of mycobacterium tuberculosis infection patients.Group B was with 45 cases after treatment in patients with recurrent.The two groups were treated with short range antituberculosis treatment,and the results of sputum,changes of TNF-α,IL-6,IL-8,IL-10,IgE indexes and therapeutic effect were observed at the time of admission and treatment for 3months.RESULTS Group A patients admitted to hospital of IL-6,IL-8and IL-10 levels were significantly lower than the group B（P〈0.05）.Two groups of TNF and IgE in comparison,the difference was not significant.After 3months of treatment,group A had sputum smear negative 18 cases and positive 13 cases,strong positive 3cases,while B group had negative 15 cases,positive 20 cases,strong positive 10 cases.Group A positive and strong positive patients with IL-6,IL-8compared with patients with negative index,the difference was not significant,but levels of IL-10,TNF-αand IgE compared with negative patients in the same group with significant difference（P〈0.05）,TNF-αand IgE compared with the same indicator same sputum test in group B with significant difference（P〈0.05）.The total effective rate in group A was 94.12% significant higher than that of the group B 77.78%（P〈0.05）.CONCLUSION The level of TNF-αand IgE in patients with pulmonary tuberculosis has important value to the clinical treatment and the infection degree of pulmonary tuberculosis.

关 键 词：肺结核 免疫球蛋白E 血清细胞因子 初治 复发 

分 类 号：R446[医药卫生—诊断学]