TGF-β、IFN-γ、IL-10与多药联合治疗肺结核产生耐药性和疗效的相关性探讨  

The relationship between TGF-β,IFN-γ,IL-10 and the drug resistance and efficacy of the multi-drug combination treatment of pulmonary tuberculosis

作　　者：李蓓[1] 张冬平[1] 张泽波[1] LI Bei;ZHANG Dongping;ZHANG Zebo(Department of Infection,Xiaogan Central Hospital (Xiaogan Hospital Affiliated to Wuhan University of Science and Technology),Xiaogan 432000,China)

机构地区：[1]孝感市中心医院(武汉科技大学附属医院)感染科,湖北孝感432000

出　　处：《东南大学学报（医学版）》2022年第1期114-120,共7页Journal of Southeast University(Medical Science Edition)

摘　　要：目的:探讨转化生长因子-β(TGF-β)、干扰素γ(IFN-γ)、白介素-10(IL-10)与多药联合治疗肺结核产生耐药性和疗效的相关性。方法:选取2018年6月至2020年6月我院165例肺结核患者,根据药敏试验结果分为耐多药组(n=44)、耐单药组(n=56)、非耐药组(n=65),比较各组TGF-β、IFN-γ、IL-10水平,采用受试者工作特征(ROC)曲线分析各指标诊断耐多药肺结核的价值,比较不同疗效患者一般资料以及血清TGF-β、IFN-γ、IL-10水平,采用多因素Logistic回归方程分析是否转阴的相关影响因素。结果:耐多药组血清TGF-β、IL-10水平高于耐单药组、非耐药组;耐单药组高于非耐药组,耐多药组血清IFN-γ水平低于耐单药组、非耐药组,耐单药组低于非耐药组(P<0.05)。血清TGF-β、IFN-γ、IL-10联合诊断耐多药肺结核的曲线下面积(AUC)为0.894,最佳诊断敏感度、特异度分别为88.64%、77.69%。转阴患者既往治疗过程有中断史者占比低于未转阴患者,治疗后血清TGF-β、IL-10水平低于未转阴患者,血清IFN-γ水平高于未转阴患者,转阴患者治疗前后差值绝对值高于未转阴者(P<0.05);血清TGF-β、IFN-γ、IL-10与耐多药肺结核患者抗结核治疗转阴情况相关(P<0.05)。结论:血清TGF-β、IFN-γ、IL-10与多药联合治疗肺结核产生耐药性及疗效显著相关。Objective:To explore the correlation of transforming growth factor-β(TGF-β),interferon-γ(IFN-γ),interleukin-10(IL-10)with multi-drug resistance and efficacy in the treatment of tuberculosis.Methods:165 patients with tuberculosis in our hospital from June 2018 to June 2020 were selected and divided into multi-drug resistant group(n=44),single-drug resistant group(n=56),and non-drug resistant group(n=65)based on the results of the drug sensitivity test,the levels of TGF-β,IFN-γ,and IL-10 in each group were compared,receiver operating characteristic(ROC)curves were used to analyze the value of each index in the diagnosis of multidrug-resistant tuberculosis,the general data of patients with different curative effects,serum levels of TGF-β,IFN-γand IL-10 were compared,multivariate Logistic regression equation was used to analyze the related affecting factors whether to turn negative.Results:Serum TGF-βand IL-10 levels in the multi-drug resistant group were higher than those in the single-drug resistant and non-drug resistant groups,the single-drug resistant group was higher than that in the non-drug resistant group;the serum IFN-γlevel in the multi-drug resistant group was lower than those in the single-drug resistant group and the non-drug resistant group,and the level in the single-drug resistant group was lower than that in the non-drug resistant group(P<0.05).The area under the curve(AUC)of the serum TGF-β,IFN-γ,IL-10 combined diagnosis of multi-drug resistant pulmonary tuberculosis was 0.894,the best diagnostic sensitivity and specificity were 88.64%and 77.69%,respectively.The proportion of negative conversion patients with a history of interruption in the previous treatment process was lower than that of non-negative patients.After treatment,the serum TGF-βand IL-10 levels were lower than those of non-negative patients,and the serum IFN-γlevels were higher than those of non-negative patients and the absolute differences of negative conversion patients before and after treatment were higher than tho

关 键 词：耐多药肺结核 转化生长因子-Β 干扰素Γ 白介素-10 抗结核疗效 诊断 

分 类 号：R521[医药卫生—内科学] R453[医药卫生—临床医学]