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目的:观察草分枝杆菌对尖锐湿疣患者血清IL-12和IL-4水平的影响,探讨草分枝杆茵对尖锐湿疣患者,Th1/Th2免疫调节作用的机制。方法:将68例尖锐湿疣患者随机分为治疗组和对照组。治疗组采用局部电灼术和肌注草分枝杆菌治疗,对照组只采用局部电灼术治疗。采用双抗体夹心ELISA法分别检测治疗前和治疗3个月后患者血清IL-12和IL-4水平的变化,并进行临床疗效的观察和生存质量的评估。结果:两组患者治疗前血清IL-12和IL-4水平比较差异均无统计学意义。治疗组治疗后血清IL-12水平较治疗前明显升高,血清IL-4水平明显降低(P<0.05);而对照组治疗前后却无明显变化。随访3个月治疗组有4例复发,对照组有13例复发,治疗组的复发率明显低于对照组(P<0.05)。两组患者治疗前生存质量评分比较差异均无统计学意义。治疗组治疗后生存质量评分明显提高,生理、心理、社会和环境4个领域的评分与治疗前比较均有明显增加(P<0.05),而对照组治疗前后却无明显变化。结论:草分枝杆菌能明显降低尖锐湿疣复发率,提高患者的生存质量。作用机制可能是通过影响IL-12,IFN-r和IL-4,IL-10等组成的细胞因子网络从整体上调节Th1/Th2免疫平衡和增强细胞免疫功能。
Objective: To observe the effect of Mycobacterium phlei on serum IL-12 and IL-4 levels in patients with condyloma acuminatum and explore the mechanism of immune regulation of Th1 / Th2 in patients with condyloma acuminatum. Methods: 68 cases of genital warts were randomly divided into treatment group and control group. The treatment group with local electrocautery and intramuscular injection of Mycobacterium tuberculosis treatment, the control group was treated with local cautery. The levels of IL-12 and IL-4 in serum of patients before and after treatment for 3 months were detected by double antibody sandwich ELISA, and the clinical efficacy and quality of life were evaluated. Results: There was no significant difference in serum IL-12 and IL-4 levels between the two groups before treatment. After treatment, serum IL-12 level in treatment group was significantly higher than that before treatment, serum IL-4 level was significantly lower (P <0.05), while the control group had no significant change before and after treatment. In the 3 months follow-up, 4 cases relapsed in the treatment group and 13 cases in the control group. The recurrence rate in the treatment group was significantly lower than that in the control group (P <0.05). The two groups of patients before treatment quality of life scores were no significant difference. After treatment, the quality of life score of the treatment group was significantly improved, and scores in the four fields of physiology, psychology, society and environment were significantly increased compared with those before treatment (P <0.05), but no significant changes were found in the control group before and after treatment. Conclusion: Mycobacterium phlei can significantly reduce the recurrence rate of genital warts and improve the quality of life of patients. The mechanism may be through the influence of IL-12, IFN-r and IL-4, IL-10 and other components of the cytokine network from the overall regulation of Th1 / Th2 immune balance and enhance cellular immune function.