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目的 探讨肺结核患者血清中免疫抑制酸性蛋白 (IAP)变化及临床应用价值。方法 采用琼脂扩散法检测 336例肺结核患者及对照组血清中免疫抑制酸性蛋白水平。结果 肺结核、健康、非结核呼吸道疾病组血清中IAP分别为 (797± 16 8)、(36 7± 71)、(4 0 4± 75 )mg/L。如果将免疫功能受抑制的阳性界值定在 >5 0 0mg/L ,则 3组的阳性率分别为 96 7%、9 2 %、9 6 % (P <0 0 5 ) ,原发型肺结核、血行播散型肺结核、浸润型肺结核、慢性纤维空洞型肺结核、结核性胸膜炎患者阳性率分别为10 0 0 %、10 0 0 %、96 0 %、98 6 %、96 9%。病情进展期肺结核患者IAP水平明显高于稳定期 ,治疗后病情好转者IAP逐逝下降。结论 测定肺结核患者血清中IAP能较直观反映其免疫抑制状况及病情严重程度 ,并对观察疗效、评判预后具有较好意义。
Objective To investigate the changes of serum immunosuppressive acid protein (IAP) in patients with pulmonary tuberculosis and its clinical value. Methods The serum immunosuppressive acid levels of 336 patients with pulmonary tuberculosis and control group were detected by agar diffusion method. Results The levels of IAP in the tuberculosis, healthy and non-tuberculosis respiratory disease groups were (797 ± 16 8), (36 7 ± 71) and (404 ± 75) mg / L, respectively. If the positive cutoff of immune function was set at> 500 mg / L, the positive rates of the three groups were 96.7%, 92% and 96%, respectively (P <0.05). The positive rates of primary pulmonary tuberculosis The positive rates of hematogenous disseminated pulmonary tuberculosis, infiltrative pulmonary tuberculosis, chronic fibrous hollow tuberculosis and tuberculous pleurisy were 10 0%, 100%, 96 0%, 98 6% and 96 9%, respectively. IAP levels in patients with advanced pulmonary tuberculosis were significantly higher than those in stable patients, and IAP decreased gradually after treatment. Conclusion The determination of IAP in the serum of patients with pulmonary tuberculosis can reflect the status of immunosuppression and the severity of the disease more intuitively, and it is of great significance to observe the curative effect and evaluate the prognosis.