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目的研究初治肺结核患者IL-2、IL-4、IL-18、IFN-γ及MMP-9的表达情况,并了解其在肺结核病治疗过程中的变化。方法应用ELLSA法检测100例初治肺结核患者治疗前后及90例健康志愿者血清IL-2、IL-4、IL-18、IFN-γ及MMP-9的表达。结果 100例结核涂阳患者,治疗2个月后79例转阴,痰菌转阴率79%;研究组与对照组比较,研究组治疗前各种细胞因子水平明显高于对照组,差异有统计学意义(P<0.01);研究组治疗后IL-4、IL-18水平高于对照组,差异有统计学意义(P<0.05),IL-2、IFN-γ及MMP-9与对照组比较,差异无统计学意义(P>0.05);研究组治疗后各种细胞因子水平明显低于治疗前(P<0.05),差异有统计学意义(P<0.05);转阴患者五种细胞因子与未转阴患者间比较,差异有统计学意义(P<0.05)。结论在进行抗肺结核物治疗时动态观察细胞因子水平,有利于监测肺结核病情的转归,利用细胞因子的变化趋势,可以预知治疗方案的有效性。
Objective To study the expression of IL-2, IL-4, IL-18, IFN-γ and MMP-9 in patients with newly diagnosed pulmonary tuberculosis and to understand their changes in the treatment of pulmonary tuberculosis. Methods The serum levels of IL-2, IL-4, IL-18, IFN-γ and MMP-9 in 100 newly diagnosed tuberculosis patients before and after treatment and 90 healthy volunteers were detected by ELLSA. Results In 100 cases of tuberculous smear-positive patients, 79 cases turned negative and the sputum negative conversion rate was 79% after 2 months of treatment. Compared with the control group, the levels of various cytokines in the study group were significantly higher than those in the control group The levels of IL-4 and IL-18 in the study group were significantly higher than those in the control group (P <0.05). The levels of IL-2, IFN-γ and MMP-9 in the study group were significantly higher than those in the control group (P <0.05). The levels of cytokines in the study group were significantly lower than those before treatment (P <0.05), the difference was statistically significant (P <0.05) The difference between cytokines and non-negative patients was statistically significant (P <0.05). Conclusions The dynamic observation of cytokine levels during the treatment of anti-TB therapy is beneficial to monitor the prognosis of pulmonary tuberculosis. The trend of cytokines can be used to predict the effectiveness of the treatment regimen.