华东地区结核病患者治疗前血清IFN-γ和IL-10水平及其影响因素  

The serum levels of IFN-γ and IL-10 in tuberculosis patients from East China before anti-tuberculosis treatment and the impact factors

作　　者：肖筱 袁立[1,2] 邱林西 陆伟[4] 蒋伟利[1,2] 赵琦[1,2] XIAO Xiao;YUAN Li;QIU Lin-xi;LU Wei;JIANG Wei-li;ZHAO Qi(Department of Epidemiology, School of Public Health , Fudan University, Shanghai 200032, China;Key Laboratory of Public HeaZth Safety of Ministry of Education, Shanghai 200032, China;Tuberculosis Prevention Institute, Jiangxi Province Center for Disease Control and Prevention, Nanchang 330046, Jiangxi Province, China;Chronic Infectious Disease Prevention Institute, J iangsu Province Center for Disease Control and Prevention, Nanj ing 210009, Jiangsu Province, China)

机构地区：[1]复旦大学公共卫生学院流行病学教研室,上海200032 [2]公共卫生安全教育部重点实验室,上海200032 [3]江西省疾病预防控制中心结核病防治所,南昌330046 [4]江苏省疾病预防控制中心慢性传染病防治所,南京210009

出　　处：《复旦学报（医学版）》2018年第3期316-322,共7页Fudan University Journal of Medical Sciences

基　　金：国家自然科学基金青年项目(C81202256);江西省科技厅资助项目(2014BDH80030)~~

摘　　要：目的探讨华东地区结核病患者治疗前体内Th1/Th2细胞因子水平及影响因素,为结核病诊疗提供有效信息。方法采用自行设计的调查问卷,选择华东两省4个研究现场结核病防治定点门诊连续调查1年(2013年4月—2014年3月),调查对象为新诊断登记的活动性结核病患者。ELISA法检测血清中细胞因子IFN-γ和IL-10水平。结果共计纳入1 289名活动性结核病患者,患者中咳嗽(83.1%)、咳痰(75.5%)症状出现频率最高。调查对象治疗前体内IFN-γ和IL-10因子水平分别为(2.086±1.119)pg/m L和(2.576±1.192)pg/m L,Th1/Th2比值为0.81(CIFN-γ/CIL-10,C代表因子浓度)。咳嗽、咳痰的患者体内IFN-γ水平较低,发热、乏力、夜间盗汗的患者IFN-γ较高(P<0.05)。初治结核病患者体内IFN-γ水平高于复治患者(P<0.05)。饮茶相对不饮茶患者体内IFN-γ水平高(P<0.05)。饮酒相对于不饮酒、规律均衡营养相对于偏食患者体内IL-10水平低(P<0.05)。结论结核病患者就诊症状值得关注,健康的饮食习惯或可帮助获得较高的免疫水平并纠正结核病患者病程中的Th1/Th2细胞因子失衡。Objective To describe the serum levels of Th1/Th2 cytokines of tuberculosis（TB） patients from East China before anti-TB treatment and the impact factors in order to provide information for TB diagnosis and treatment. Methods Four fields of TB appointed hospitals from two provinces in East China were selected. All newly diagnosed and registered active TB patients from Apr.,2 0 1 3 to Mar.,2 0 1 4 were investigated by self-designed questionnaire. ELISA was used to test the levels of IFN-γ and IL-1 0 in the serum. Results Totally 1 2 8 9 active TB patients were enrolled in the study sites,of whom 8 3. 1 % and 7 5. 5 % were reported having cough and sputum,respectively. The levels of IFN-γ and IL-1 0 were（2. 0 8 6 ± 1. 1 1 9） pg/m L and（2. 5 7 6 ± 1. 1 9 2） pg/m L,respectively. The ratio of Th1/Th2 was 0. 81（CIFN-γ/CIL-10,C stands for concentration）. The level of IFN-γwas lower in patients with cough and sputum,while it was higher in those with fever,fatigue and night sweats（P 〈0. 05）. In addition,the level of IFN-γ in initial treatment patients was higher than that in retreatment cases（P 〈0. 05）. It was found that drinking tea could raise the level of IFN-γ（P 〈0. 05）,drinking wine and taking a regular balanced diet could reduce the level of IL-10（P〈 0. 05）. Conclusions The symptoms of TB patients deserved attention. A healthy eating habits can help to achieve a high level of immunity and to correct the imbalance of Th1/Th2 cytokines in the course of disease.

关 键 词：结核病 症状 细胞因子 TH1/TH2 IFN-Γ IL-10 

分 类 号：R521[医药卫生—内科学] R183.3[医药卫生—临床医学]