TP患者治疗前后胸腔积液中巨噬细胞及炎性细胞因子的改变  

Changes of Macrophage Polarization and Inflammatory Factors in Pleural Effusion in Patients with Tuberculous Pleurisy before and after Treatment

作　　者：孙峰[1] 王海月 燕存子[1] Sun Feng;Wang Haiyue;Yan Cunzi(Department of Respiratory Diseases,The First Affiliated Hospital of Xinjiang Medical University,Xinjiang 830054,China)

机构地区：[1]新疆医科大学第一附属医院呼吸与呼吸危重症中心,乌鲁木齐830054

出　　处：《医学研究杂志》2021年第2期86-89,152,共5页Journal of Medical Research

基　　金：新疆维吾尔自治区自然科学基金青年科学基金资助项目(2018D01C207)。

摘　　要：目的探讨结核性胸膜炎(TP)患者胸腔积液中M1、M2型巨噬细胞比例及相关炎性细胞因子在抗结核治疗前后的变化及意义。方法前瞻性纳入2018年10月~2019年9月到笔者医院就诊的新发TP患者,采用流式细胞术检测抗结核治疗前后胸腔积液中M1型(CD14^(+)CD86^(+))与M2型(CD14^(+)CD163^(+))巨噬细胞的变化,酶联免疫吸附法测定胸腔积液中IL-10、IL-12、ADA的含量。结果共纳入125例TP患者,治疗后M1、M2型巨噬细胞均较治疗前增多,且M2型增高更明显,M2/M1比例显著增高(P<0.05)。治疗后胸腔积液中IL-10、IL-12水平较治疗前下降,ADA无明显变化。抗结核治疗前IL-12与M1型巨噬细胞呈正相关,但治疗后无明显相关性。治疗前后IL-10与M2型巨噬细胞均无显著相关性。结论在TP患者胸腔积液中巨噬细胞向M1型极化,分泌大量IL-12,抗结核治疗可使向M2型转化,降低炎性细胞因子水平。Objective To investigate the changes of M1 and M2 macrophages in the tuberculous pleural effusion before and after anti-tuberculous treatment.Methods The tuberculous pleurisy(TP)patients who admitted to our hospital from October 2018 to September 2019 were enrolled prospectively.The proportion of M1(CD14+CD86+)and m2-type(CD14+CD163+)macrophages in pleural fluid were detected by flow cytometry before and after anti-tuberculosis treatment.The contents of interleukin-10(IL-10),interleukin-12(IL-12)and adenosine deaminase(ADA)in pleural effusion were determined by enzyme-linked immunoadsorption.Results A total of 125 TP patients were enrolled.After treatment,both M1 and M2 macrophages increased compared with those before treatment,and the M2 increased more significantly,and the M2/M1 ratio increased significantly(P<0.05).After treatment,IL-10 and IL-12 in pleural effusion decreased compared with before treatment,and there was no significant change in ADA.There was a positive correlation between IL-12 and M1 macrophages pre-treatment,but there was no significant correlation post-treatment.There was no significant correlation between IL-10 and M2 macrophages before and after treatment.Conclusion In the pleural effusion of TP patients,macrophages polarized to M1 type and secreted a large amount of IL-12.Antituberculosis therapy can transform macrophages into M2 and reduce the level of inflammatory factors.

关 键 词：结核性胸膜炎 巨噬细胞 极化 治疗 炎性细胞因子 

分 类 号：R521.7[医药卫生—内科学]