老年COPD患者合并结核分枝杆菌感染的危险因素及IFN-γ、sIL-2R、Ag85B水平变化  

Risk factors for Mycobacterium tuberculosis infection and changes of IFN-γ,sIL-2R and Ag85B in elderly patients with COPD

作　　者：吴秋静 史可云[1] 胡杰 陈芸 谢婧[1] 徐晓娟 WU Qiu-jing;SHI Ke-yun;HU Jie;CHEN Yun;XIE Jing;XU Xiao-juan(Yiring People's Hospital,Wuri,Jiangsu 214200,China)

机构地区：[1]宜兴市人民医院老年医学科,江苏无锡214200

出　　处：《中华医院感染学杂志》2024年第9期1336-1339,共4页Chinese Journal of Nosocomiology

基　　金：江苏省卫生健康委科研项目(JDYY2023065)。

摘　　要：目的探讨老年慢性阻塞性肺疾病(COPD)合并结核分枝杆菌感染的危险因素及对γ-干扰素(IFN-γ)、可溶性白细胞介素-2受体(sIL-2R)、抗原85B(Ag85B)水平的影响。方法选取2018年8月-2023年5月宜兴市人民医院收治的104例老年COPD合并结核分枝杆菌感染患者为研究组,随机选取同期104例单纯COPD患者为对照组,分析老年COPD患者合并结核分枝杆菌感染的危险因素,检测两组患者血清IFN-γ、sIL-2R、Ag85B表达水平。结果多因素Logistic回归分析结果显示,年龄大、吸烟史、粉尘暴露史、吸入糖皮质激素、营养不良均是老年COPD患者合并结核分枝杆菌感染的危险因素(OR=1.992、2.092、2.162、1.964、2.132;P<0.05);研究组血清IFN-γ、sIL-2R、Ag85B水平均高于对照组(P<0.05),且随结核病变程度加重而上升(P<0.05)。结论老年COPD合并结核分枝杆菌感染与年龄、吸烟史、粉尘暴露史、吸入糖皮质激素及营养不良等密切相关,并导致血清IFN-γ、sIL-2R、Ag85B水平升高,且随结核病变程度加重而上升。OBJECTIVE To explore the risk factors for Mycobacterium tuberculosis infection in the elderly patients with chronic obstructive pulmonary disease(COPD)and observe the influence on levels of interferon-γ(IFN-γ),soluble interleukin-2 receptor(sIL-2R)and antigen 85B(Ag85B).METHODS A total of 104 elderly patients with COPD who were complicated with M.tuberculosis infection and treated I n Yixing People′s Hospital from Aug 2018 to May 2023 were assigned as the study group,meanwhile,104 patients with simple COPD were randomly chosen as the control group.The risk factors for the M.tuberculosis infection in the elderly COPD patients were analyzed,and the expression levels of serum IFN-γ,sIL-2R and Ag85B were observed and compared between the two groups of patients.RESULTS The result of multivariate logistic regression analysis showed that the old age,smoking history,history of exposure to dust,inhalation of glucocorticoids and malnutrition were the risk factors for the M.tuberculosis infection in the elderly COPD patients(OR=1.992,2.092,2.162,1.964,2.132;P<0.05).The levels of serum IFN-γ,sIL-2R and Ag85B of the study group were significantly higher than those of the control group(P<0.05),and the level of above indexes were significantly elevated with the aggravation of tuberculosis(P<0.05).CONCLUSION The M.tuberculosis infection in the elderly COPD patients is closely associated with the age,smoking history,history of exposure to dust,inhalation of glucocorticoids and malnutrition and leads to the rise of serum IFN-γ,sIL-2R and Ag85B,and the levels of the above indexes are elevated with the aggravation of tuberculosis.

关 键 词：慢性阻塞性肺疾病 结核分枝杆菌 Γ-干扰素 可溶性白细胞介素-2受体 抗原85B 

分 类 号：R563[医药卫生—呼吸系统]