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目的评价6种血清细胞因子与肺纤维化及其功能损害程度间的关系。方法测定133例肺结核患者的肺功能、胸部HRCT和血细胞因子,根据肺功能结果分为正常组(47例)、限制性轻度减退组(36例)、限制性显著减退组(25例)和限制性严重减退组(25例)。并计算反映肺纤维化程度的HRCT分值。结果肺功能4组中,血清细胞因子IL-1、IL-2、IL-5、IL-6、IFN-Υ、TNF-α的均值经检验H值分别为101.282、96.454、0.990、0.538、102.300、97.715,提示IL-1、IL-2、IFN-Υ、TNF-α的均数在4组间的差异有统计学意义(P=0.000)。HRCT分值的变化范围是1~15分,IL-1、TNF-α与HRCT分数呈显著正相关(分别为R=0.757P=0.000,R=0.972P=0.000),而IL-2、IFN-Υ与HRCT分数呈显著负相关(分别为R=-0.738P=0.000,R=-0.750P=0.000),IL-5、IL-6与HRCT分数无关(分别为R=0.102P=0.241,R=0.048P=0.584)。按HRCT分数的大小,将133例病人分为低分组(99例)和高分组(34例),IL-1、TNF-α的均数在2组的差异有统计学意义(P=0.000)。各细胞因子之间也存在相互关系,其中IL-1和TNF-α,IL-5和IL-6以及IL-2和IFN-Υ之间关系密切,而且变化方向相同。IL-1和IL-2,IL-1和IFN-Υ,IL-2和TNF-α以及IFN-Υ和TNF-α之间关系亦非常密切,但变化方向相反。结论血清细胞因子与肺结核患者的肺功能、肺纤维化程度有相关性,其中IL-1、TNF-α的相关性最强。
Objective To evaluate the relationship between six serum cytokines and pulmonary fibrosis and the degree of functional impairment. Methods Pulmonary function, thoracic HRCT and hemocytokine were determined in 133 patients with pulmonary tuberculosis. According to pulmonary function, the patients were divided into normal group (n = 47), restrictive mild hypothyroidism group (n = 36), restrictive reduction group (n = 25) Severe restrictive group (25 cases). HRCT scores reflecting the degree of pulmonary fibrosis were calculated. Results The mean values of serum cytokines IL-1, IL-2, IL-5, IL-6, IFN-γ and TNF-α in the four groups of lung function were 101.282,96.454,0.990,0.538,102.300 , 97.715, suggesting that the mean of IL-1, IL-2, IFN-γ and TNF-α in the four groups were statistically different (P = 0.000). HRCT scores ranged from 1 to 15, with significant positive correlations between IL-1, TNF-α and HRCT scores (R = 0.757 P = 0.000 and R = 0.972 P = 0.000, respectively) -Y was negatively correlated with HRCT scores (R = -0.738 P = 0.000, R = -0.750 P = 0.000, respectively), IL-5 and IL-6 were not associated with HRCT scores (R = 0.102 P = R = 0.048P = 0.584). According to the HRCT score, 133 patients were divided into low group (99 cases) and high group (34 cases). There was significant difference between the two groups in the mean of IL-1 and TNF-α (P = 0.000) . There is also a correlation between the various cytokines, of which IL-1 and TNF-α, IL-5 and IL-6 and IL-2 and IFN-γ are closely related, and the same direction of change. IL-1 and IL-2, IL-1 and IFN-γ, IL-2 and TNF-α as well as IFN-γ and TNF-α were also closely related, but in opposite directions. Conclusions There is a correlation between serum cytokines and lung function and pulmonary fibrosis in patients with pulmonary tuberculosis. Among them, IL-1 and TNF-α have the strongest correlation.