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目的探讨肺结核患者的血清可溶性白介素-2受体(sIL-2R)、γ干扰素(IFN-γ)、肿瘤坏死因子α(TNF-α)、白介素-6(IL-6)的变化及意义。方法采用双抗体夹心ABC-ELISA法测定214例初治肺结核的血清中sIL-2R、TNF-α、IL-6、IFN-γ的水平。结果肺结核病人血清sIL-2R的检测结果各组平均值均高于正常,随着病灶范围增加sIL-2R的水平也增加;3～4肺野组与5～6肺野组sIL-2R水平明显高于1～2肺野组(P<0.01);痰菌阳性组sIL-2R水平明显高于阴性组(P<0.01)。肺结核病人血清TNF-α的检测结果显示1～2肺野组与3～4肺野组平均值均高于正常,随着病灶范围增加TNF-α的水平减少,5～6肺野组在正常范围,1～2肺野组TNF-α的水平明显高于5～6肺野组(P<0.01);无空洞组TNF-α平均值高于有空洞组(P<0.05)。肺结核病人的血清INF-γ的检测结果显示各组平均值均高于正常,其中5～6个肺野组比3～4肺野组高(P<0.05);痰菌阳性组比阴性组IFN-γ水平高(P<0.05)。结论不同肺结核患者外周血中sIL-2R、TNF-α、IFN-γ、IL-6水平存在着差异,这些细胞因子可能在结核病的发病中起着一定的作用。
Objective To investigate the changes of serum soluble interleukin-2 receptor (sIL-2R), interferon-γ (IFN-γ), tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) in patients with pulmonary tuberculosis. Methods Serum levels of sIL-2R, TNF-α, IL-6 and IFN-γ in 214 newly diagnosed tuberculosis patients were determined by double antibody sandwich ABC-ELISA. Results The serum levels of sIL-2R in patients with pulmonary tuberculosis were higher than normal in all groups, and the level of sIL-2R increased with the range of lesions. The levels of sIL-2R in lung-lung group and lung-field group were significantly higher (P <0.01). The level of sIL-2R in sputum positive group was significantly higher than that in negative group (P <0.01). The results of the detection of serum TNF-α in patients with tuberculosis showed that the mean values of TNF-α in 1-2 lung field group and 3-4 lung field group were all higher than those in the normal group. The level of TNF- (P <0.01). The average level of TNF-α in the non-voided group was higher than that in the non-voided group (P <0.05). The result of INF-γin the pulmonary tuberculosis patients showed that the average value of each group was higher than normal, of which 5 ~ 6 lung field group than the 3 ~ 4 lung field group (P <0.05); sputum positive group than the negative group IFN -γ levels were high (P <0.05). Conclusion There are differences in the levels of sIL-2R, TNF-α, IFN-γ and IL-6 in different kinds of pulmonary tuberculosis patients. These cytokines may play a role in the pathogenesis of tuberculosis.