慢性阻塞性肺疾病合并肺结核患者血清细胞因子变化及意义分析  

Changes and significance of serum cytokines in patients with chronic obstructive pulmonary disease and pulmonary tuberculosis

作　　者：苏圆圆[1] 戎燕筱 王倩 孙雪培 王海宾[1] 王慰[1] SU Yuan-yuan;RONG Yan-xiao;WANG Qian;SUN Xue-pei;WANG Hai-bin;WANG Wei(Shijiazhuang Fifth Hospital,Shijiazhuang 050021,China)

机构地区：[1]河北省石家庄市第五医院,河北石家庄050021

出　　处：《实用医院临床杂志》2023年第6期68-72,共5页Practical Journal of Clinical Medicine

基　　金：河北省医学科学研究课题(编号:20220203)。

摘　　要：目的分析可溶性白细胞介素2受体(sIL-2R)、可溶性髓系细胞触发受体1(sTREM-1)及白细胞介素1(IL-1)在慢性阻塞性肺疾病(COPD)合并肺结核(PTB)患者血清中的表达及临床意义。方法选取2019年1月至2021年6月我院收治的52例合并COPD的活动性PTB患者(A组),50例单纯COPD患者(B组)和50例不合并COPD的活动性PTB患者(C组)。比较三组血清中sIL-2R、sTREM-1、IL-1及细胞免疫指标差异,分析各指标之间的相关性。根据观察期内(治疗2个月后)A组治疗情况分为好转租和恶化组,比较两组sIL-2R、sTREM-1、IL-1水平,分析sIL-2R、sTREM-1、IL-1对COPD合并PTB患者预后的预测价值。结果三组血清sIL-2R、sTREM-1、IL-1、CD8^(+)比较,A组>C组>B组,CD4^(+)、CD4^(+)/CD8^(+)比较,A组<C组<B组(P<0.01);A组入院时血清sIL-2R、sTREM-1水平与CD4^(+)/CD8^(+)负相关,与CD8^(+)正相关(P<0.01),IL-1与CD8^(+)正相关(P<0.05);A组观察期内病情好转34例,恶化18例,好转组血清sIL-2R、sTREM-1、IL-1均低于恶化组(P<0.05);sIL-2R、sTREM-1、IL-1联合检测对COPD合并PTB患者不良预后的ROC曲线下面积(AUC)为0.884,高于sIL-2R、sTREM-1、IL-1单独预测(P<0.05)。结论COPD合并PTB患者血清sIL-2R、sTREM-1、IL-1明显异常,其表达与免疫功能可能存在联系,联合监测三者水平变化或许可预测COPD合并PTB患者预后。Objective To analyze the expression and clinical significance of soluble interleukin-2 receptor(sIL-2R),soluble myeloid cell trigger receptor 1(sTREM-1)and interleukin-1(IL-1)in the serum of patients with chronic obstructive pulmonary disease(COPD)and pulmonary tuberculosis(PTB).Methods This research included 52 patients with COPD and active PTB(group A),50 patients with COPD(group B)and 50 patients without COPD but with active PTB(group C)treated in our hospital from January 2019 to June 2021.Serum sIL-2R,sTREM-1,IL-1 and cellular immune indicators were compared among the three groups.The correlation of these indicators was analyzed.According to the treatment status of the group A during the observation period(after 2 months of treatment),the patients in this group were divided into an improvement group and a deterioration group.The levels of sIL-2R,sTREM-1 and IL-1 were compared between the two groups.The prognostic value of sIL-2R,sTREM-1 and IL-1 in patients with COPD and PTB was analyzed.Results Comparison of serum sIL-2R,sTREM-1 and IL-1 as well as CD8^(+)among the three groups showed that the group A>the group C>the group B.Comparison of CD4^(+)and CD4^(+)/CD8^(+)showed that the group Athe group Cthe group B.The all differences were statistically significant(P<0.01).In the group A at admission,the levels of serum sIL-2R and sTREM-1 were negatively correlated with CD4^(+)/CD8^(+)and positively correlated with CD8^(+)(P<0.01).The levels IL-1 in the group A was positively correlated with CD8^(+)(P<0.05).In the group A,there were 34 patients improved and 18 patients deteriorated during the observation period.The levels of serum sIL-2R,sTREM-1 and IL-1 in the improvement group were lower than those in the deterioration group(P<0.05).The area under the ROC curve(AUC)of sIL-2R combined with sTREM-1 and IL-1 for predicting poor prognosis of patients with COPD and PTB was 0.884,which was higher than that of each index alone(P<0.05).Conclusions The levels of serum sIL-2R,sTREM-1 and IL-1 are significantly abnormal i

关 键 词：慢性阻塞性肺疾病 肺结核 可溶性白细胞介素2受体 可溶性髓系细胞触发受体1 白介素1 

分 类 号：R563[医药卫生—呼吸系统]