肺结核患者血清白细胞介素17、CD4^+、CD3^+ 细胞表达变化及其意义探讨  

Expressions and significance of serum interleukin17,CD4^+and CD3^+in patients with pulmonary tuberculosis

作　　者：陈勇[1] 凌建 何静[2] 谭春萍[3] 余江萍 杨琴[1] CHEN Yong;LING Jian;HE Jing;TAN Chun-ping;YU Jiang-ping;YANG Qin(Department of Laboratory,Mianyang People's Hospital,Mianyang 621000,China;Department of Laboratory,Mianyang 404 Hospital,Mianyang 621000,China;Department of Laboratory,Panzhihua Second People's Hospital,Panzhihua 617000,China;Department of Otolaryngology,Panzhihua Second People's Hospital,Panzhihua 617000,China)

机构地区：[1]四川省绵阳市人民医院检验科,四川绵阳621000 [2]四川绵阳四〇四医院检验科,四川绵阳621000 [3]四川省攀枝花市第二人民医院检验科,四川攀枝花617000 [4]四川省攀枝花市第二人民医院耳鼻喉科,四川攀枝花617000

出　　处：《实用医院临床杂志》2020年第6期142-145,共4页Practical Journal of Clinical Medicine

基　　金：四川省绵阳市卫健委科研基金资助项目(编号:201846)。

摘　　要：目的探讨肺结核患者血清白细胞介素17(IL-17)及外周血T淋巴细胞亚群(CD4^+、CD3^+)表达变化及其意义。方法选择104例肺结核患者(肺结核组),同期92例非结核呼吸系统疾病患者(对照组)。比较肺结核组治疗前后及与对照组血清IL-17和外周血CD4^+、CD3^+水平差异,评估治疗前血清IL-17及外周血CD4^+、CD3^+对肺结核的诊断价值;根据肺结核患者治疗前肺部病灶受累情况分为多叶受累组、病灶局限组,根据治疗后病灶吸收情况分为病灶吸收良好组、病灶吸收不良组,分析病灶特征与血清IL-17及外周血CD4^+、CD3^+水平的关系。结果治疗6个月后,肺结核组血清IL-17及外周血CD4^+、CD3^+水平均较治疗前升高,肺结核组治疗前后血清IL-17及外周血CD4^+、CD3^+水平均低于对照组(P<0.05)。治疗前血清IL-17及外周血CD4^+、CD3^+对肺结核有较高诊断价值(AUC=0.793、0.827、0.738,P<0.05),Cut-off值分别为65.20 pg/ml、41.50%、65.50%。104例肺结核患者中多叶受累组69例(66.35%),病灶局限组35例(33.65%);多叶受累组治疗前血清IL-17及外周血CD4^+、CD3^+水平低于病灶局限组(P<0.05);病灶吸收良好组41例(39.42%),病灶吸收不良组63例(60.58%);病灶吸收良好组治疗后血清IL-17及外周血CD4^+、CD3^+水平高于病灶吸收不良组(P<0.05)。肺结核患者病灶受累程度与治疗前血清IL-17及外周血CD4^+、CD3^+呈负相关,病灶吸收程度与治疗后血清IL-17及外周血CD4^+、CD3^+呈正相关(P<0.05)。结论血清IL-17及外周血CD4^+、CD3^+不仅能辅助诊断肺结核,还与患者病情严重程度及疗效密切相关,于肺结核临床诊疗有利。Objective To explore the expressions and significance of serum interleukin 17(IL-17)and peripheral blood T lymphocyte subsets(CD4^+and CD3^+)in patients with pulmonary tuberculosis.Methods One hundred and four patients with pulmonary tuberculosis(pulmonary tuberculosis group)and 92 patients without tuberculosis respiratory diseases(control group)were included.The levels of serum IL-17 and peripheral blood CD4^+and CD3^+were compared in the pulmonary tuberculosis group before and after treatment and control group.The diagnostic value of serum IL-17 and peripheral blood CD4^+and CD3^+before treatment of pulmonary tuberculosis was evaluated.According to the pulmonary lesion involvement in patients with pulmonary tuberculosis before treatment,the patients were further divided into multi-lobe involvement group and lesion limitation group.According to the lesion absorption after treatment,the patients were also divided into good lesion absorption group and poor lesion absorption group.The relationship between lesion characteristics and levels of serum IL-17 and peripheral blood CD4^+and CD3^+was analyzed.Results After 6 months of treatment,the levels of serum IL-17 and peripheral blood CD4^+and CD3^+in the pulmonary tuberculosis group were higher than those before treatment,and the levels of serum IL-17 and peripheral blood CD4^+and CD3^+in pulmonary tuberculosis group before and after treatment were lower than those in the control group(P<0.05).Serum IL-17 and peripheral blood CD4^+and CD3^+before treatment had high diagnostic value for pulmonary tuberculosis(AUC=0.793,0.827 and 0.738,respectively,P<0.05),and their cut-off values were 65.20 pg/ml,41.50%and 65.50%.Among the 104 patients with pulmonary tuberculosis,there were 69 cases(66.35%)in the multi-lobe involvement group and 35 cases(33.65%)in the lesion limitation group.The levels of serum IL-17 and peripheral blood CD4^+and CD3^+in the multi-lobe involvement group before treatment were lower than those in the lesion limitation group(P<0.05).There were 41 cases(3

关 键 词：肺结核 白细胞介素17 CD4^+ CD3^+ 肺部病灶 多叶受累 吸收 

分 类 号：R521[医药卫生—内科学]