菌阳肺结核患者治疗前后临床免疫学研究.docVIP

精品论文 参考文献 菌阳肺结核患者治疗前后临床免疫学研究 仲维高 陈爱琴 刘冰 　　（川北医学院第二附属医院 四川绵阳四0四医院 621000） 　　【摘 要】探讨菌阳肺结核患者治疗前后及转阴与未转阴肺结核患者血清TNF-alpha;、IL-2、 IL-4、IL-6、IL-8水平变化及细胞凋亡率变化及临床意义，阐明细胞因子在结核发病中作用及与细胞凋亡相关性。方法：采用ELISA法检测80例菌阳肺结核患者和20名正常人及菌阳肺结核治疗后65例转阴及15例未转阴肺结核患者血清TNF-alpha;、IL-2、 IL-4、IL-6、IL-8水平变化及CD4+T细胞凋亡率改变，并检测各组肺结核患者细胞凋亡率变化。结果：菌阳肺结核组治疗前后血清及转阴肺结核组与未转阴肺结核组TNF-alpha;等细胞因子水平及CD4+T细胞凋亡率有统计学意义，且上述患者临床症状改善，痰菌阴转，胸片病灶吸收好转、空洞缩小。结论：细胞因子TNF-alpha;、IL-2、 IL-4、IL-6、IL-8在菌阳肺结核发病、转阴中起重要作用，与CD4+T细胞凋亡相关。 　　【关键词】肺结核；细胞因子；细胞凋亡 　　【中图分类号】R521 【文献标识码】B 【文章编号】1003-5028（2015）8-0584-02 　　To study Clinical Immunology changes in sputum positive pulmonary tuberculosis patients before and after treatment 　　Zhong-weigao Chen-aiqin Liu-bin 　　（Second Affiliated Hospital of North Sichuan Medical College） 　　【Abstract】To study the TNF-alpha;, IL-2, IL-4, IL-6, IL-8 levels and apoptosis rate in sputum positive pulmonary tuberculosis patients before and after treatment and serum negative and not negative tuberculosis, Result：There were significant differences for the values of five cytokines in TB group before and after treatment and the control group，and also the same as CD4+ T cell apoptosis；There were significant differences for the values of five cytokines in TB group before and after treatment and the control group，and also the same as CD4+ T cell apoptosis. after 2 months of standard treatment in the TB group. and the above improvement in clinical symptoms, sputum conversion, chest lesions improved absorption, reduced empty. Conclusion: the cytokine plays an important role in the sputum positive pulmonary tuberculosis, tuberculosis was negative, clearly associated with CD4+ T cell apoptosis. 　　【Key words】tuberculosis ; cytokines ; apoptosis 　　结核病是由T细胞参与与免疫反应密切相关慢性呼吸道传染病，是全球关注公共卫生和社会问题。细胞免疫反应在结核发病过程占主导地位。IL及TNF-alpha;等细胞因子(CK) 参与结核病免疫应答及发病过程[1]。一定程度上CK可反映患者免疫状态，对预后，药物疗效评估有重要意义。IL、TNF-alpha;等CK有广泛生物学活性，在肺结核发病中起重要作用。另研究表明肺结核发病、发展与CD4+、CD8+细胞凋亡密切相关，且参与细胞免疫过程[2、3]。本研究通过检测初治肺结核菌阳患者标准强化治疗前后IL - 2、IL-4、IL-6、IL-8及