结核患者血清TNF-α、IL-1、IL-10和HMGB-1动态变化及临床意义  

The dynamic changes of serum TNF-α,IL-1,IL-10 and HMGB-1 during tuberculosis disease progression

作　　者：周安[1] 徐巧玲[2] 李明强[1] 刘清蒙[1] 

机构地区：[1]遵义医学院微生物学教研室,563000 [2]贵州航天医院肺科,贵州省遵义市563003

出　　处：《实用医学杂志》2017年第2期285-288,共4页The Journal of Practical Medicine

基　　金：贵州省卫生厅基金课题(编号:D-308)

摘　　要：目的:探讨结核患者血清中TNF-α和IL-1、IL-10及HMGB-1的动态变化规律和临床意义。方法:选取活动性结核59例,按标化治疗并评估疗效。采集不同治疗时间患者和对照外周血,ELISA测定血清炎症因子。结果:初治、复治肺结核和肺外结核患者外周血TNF-α、IL-1和HMGB-1水平随化疗进行及病情好转而明显下降(P<0.01),IL-10水平显著回升(P<0.01)。治疗前,临床治愈与治疗失败患者4种炎症因子无差异(P>0.05)。治疗结束时,治疗失败患者TNF-α、IL-1和HMGB-1均显著高于正常人水平(P<0.01),而IL-10却显著低于正常人水平(P<0.01)。结论:动态检测活动性结核患者外周血TNF-α、IL-1、IL-10和HMGB-1水平有助于活动性结核患者病情评估和疗效判断。Objective To investigate the dynamic changes and clinical significanes of TNF-α,IL-1,IL-10 and HMGB-1 in patients with tuberculosis. Methods Fifty-nine patients with active tuberculosis were enrolled inthis study. The patients received the standard chemotherapy and the curative effect of the patient was evaluatedaccording to the outcome classification in our country. The peripheral blood serum from the patients during thetreatment and 12 healthy volunteers were collected. The concentrations of serum TNF-α,IL-1,IL-10 and HMGB-1were detected by ELISA tests. Results Significant decreases of the concentrations of serum TNF- α,IL-1 andHMGB-1 were shown in patients from the initial treatment,to retreatment and extra-pulmonary tuberculosis（P〈0.01）,and the serum IL-10 was increased significantly（P〈0.01） along with the chemotherapy and improvement ofthe disease. At the beginning of the treatment,the levels of 4 kinds of inflammatory factors had no significantdifferences between the completed and uncompleted treatment patients（P〉0.05）. At the end of the treatment,the levels of serum TNF-α,IL-1 and HMGB-1 of the uncompleted treatment group were significantly higher thanthe normal levels（P0.01）,but the level of IL-10 was significantly lower than the normal level（P〈0.01）.Conclusion The dynamic testing of the inflammatory cytokines contributes to evaluation and judgement of thecurative effect and the condition of patients with the active tuberculosis.

关 键 词：活动性结核 TNF-α IL-1 IL-10 HMGB-1 动态检测 

分 类 号：R52[医药卫生—内科学]