敏感肺结核患者血清IL-1、IL-10水平表达的临床意义及对预后的影响  

Clinical significance of serum IL-1 and IL-10 expression in patients with sensitive pulmonary tuberculosis and its influence on prognosis

作　　者：黄远江 陈琼 林石宁 蔡暖暖 Huang Yuanjiang;Chen Qiong;Lin Shining;Cai Nuannuan(Infectious and Tropical Disease Department,the Second Affiliated Hospital of Hainan Medical University,Haikou 570100,China;Department of Respiratory Medicine,the Second Affiliated Hospital of Hainan Medical University,Haikou 570100,China;Department of Respiratory Medicine,Hainan Provincial People′s Hospital,Haikou 570100,China)

机构地区：[1]海南医学院第二附属医院感染病与热带病科,海口570100 [2]海南医学院第二附属医院呼吸内科,海口570100 [3]海南省人民医院呼吸科,海口570100

出　　处：《国际呼吸杂志》2022年第20期1530-1535,共6页International Journal of Respiration

摘　　要：目的探讨敏感肺结核患者血清白细胞介素1(IL-1)、IL-10水平表达情况, 并分析两指标与患者预后的关系。方法采用前瞻性队列研究。选取2017年5月至2018年5月海南医学院第二附属医院敏感肺结核患者为研究对象。患者均接受2HRZE/4HR方案治疗(至少6个月), 并在患者治愈后持续随访2年(至2020年5月), 随访期间, 患者接受痰结核分枝杆菌厚涂片、痰菌培养等检查, 并记录相关结果及痰菌复发的情况。根据随访结果分为预后良好组(未复发)与预后不良组(复发)。自制基线资料调查问卷调查患者一般人口学特征;采用酶联免疫吸附法测定血清IL-1、IL-10、C反应蛋白(CRP)、肿瘤坏死因子α(TNF-α)、干扰素γ(INF-γ)水平;全自动血细胞分析仪测定白细胞计数(WBC)。比较2组一般资料及实验室指标, 并进行logistic回归分析;绘制受试者工作特征曲线, 分析IL-1、IL-10预测敏感肺结核患者治疗后短期预后不良的价值;双变量Pearson直线相关性检验敏感肺结核患者血清IL-1和IL-10的关系。结果本研究共纳入200例敏感肺结核患者, 其中11例治疗失败剔除本次研究, 5例失访, 最终184例患者纳入本次研究。随访2年, 经评估184例敏感肺结核患者中18例治愈后复发, 预后不良发生率为9.78%(18/184)。预后不良组患者WBC、CRP、TNF-α、INF-γ、IL-1、IL-10均高于预后良好组(P值均<0.05);经logistic回归分析检验结果显示, 敏感肺结核患者IL-1、IL-10与预后有关(OR=1.68、5.00, P值均<0.05);WBC、CRP、TNF-α、INF-γ与肺结核患者预后结局无关(P值均>0.05);绘制受试者工作特征曲线, 结果显示, 入院时血清IL-1、IL-10单独及联合预测敏感肺结核患者预后不良的曲线下面积分别为0.88、0.88、0.93, 均有一定预测价值;经Spearman相关性分析检验, 敏感肺结核患者血清IL-1与IL-10水平呈正相关(r=0.28, P<0.05)。结论敏感肺结核患者血清IL-1、IL-10水平表�Objective To explore the expression of serum interleukin-1(IL-1)and IL-10 in patients with sensitive pulmonary tuberculosis and to analyze the relationship between the two indexes and the prognosis of patients.Methods A prospective cohort study was conducted.Patients with sensitive pulmonary tuberculosis in the Second Affiliated Hospital of Hainan Medical University from May 2017 to May 2018 were selected as the research subjects.All patients were treated with 2HRZE/4HR regimen(at least 6 months),and were followed up for 2 years(until May 2020)after the patients were cured.During the follow-up period,the patients received sputum mycobacterium tuberculosis thick smear,sputum bacteria culture,and other examinations,and the relevant results and sputum bacteria recurrence were recorded.According to the follow-up results,the patients were divided into two groups:good prognosis group(no recurrence)and poor prognosis group(recurrence).The general demographic characteristics of the patients were investigated by self-made baseline data questionnaire.The serum levels of IL-1,IL-10,C-reactive protein(CRP),tumor necrosis factor-α(TNF-α),and interferon-γ(INF-γ)were measured by enzyme-linked immunosorbent assay.White blood cell count(WBC)was measured by automatic blood cell analyzer.The general data and laboratory indexes of the two groups were compared and logistic regression analysis was carried out.The ROC curve was drawn to analyze the value of IL-1 and IL-10 in predicting the poor short-term prognosis of sensitive pulmonary tuberculosis patients after treatment.Bivariate Pearson linear correlation test was used to test the relationship between serum IL-1 and IL-10 in patients with sensitive pulmonary tuberculosis.Results A total of 200 patients with sensitive pulmonary tuberculosis were included in this study,of which 11 were excluded from this study due to treatment failure.Five patients were lost to follow-up,and 184 patients were included in this study.After a follow-up of 2 years,18 of 184 patients with sensitive

关 键 词：结核 肺 白细胞介素1 白细胞介素10 预后 

分 类 号：R521[医药卫生—内科学]