复治肺结核患者血清IL-18、IL-6和NO测定及其临床意义

摘要

Objective:To discuss the change of serum interleukin-18(IL-18),interleukin-6(IL-6) and nitric oxide(NO) expression levels in retreatment TB patients and its significance.Method:120 cases of retreatment TB patients in Bao’an District Central Hospital of Shenzhen City from January 2012 to December 2014 were selected as the observation group.28 cases with 2 types or less than 2 types of drug resistance were as the low resistance group,45 cases with 3 or 4 types of drug resistance were as the moderate resistance group,47 cases with more than 4 types of drug resistant were as the high resistant group.After treatment,66 cases who were cured were as the treated group,54 cases who were not cured were as the untreated group.Simultaneously 60 cases of normal healthy people were selected as the control group.They were respectively fasted venous blood.The serum NO,IL-18,IL-6 levels of different groups were analyzed and compared.Result:Before treatment,the serum levels of IL-18,IL-6 and NO were significantly higher than those of the control group,the differences were statistically significant(P<0.05).The serum levels of IL-18,IL-6 and NO from high to low were the high resistance group>the moderate resistance group>the low resistance group,the differences were statistically significant(P<0.05).After treatment,the serum levels of IL-18,IL-6 and NO of the two groups were lower than before,the serum levels of IL-18,IL-6 and NO of the treated group were lower than those of the untreated group,the differences were statistically significant(P<0.05).There were no statistically significant differences in the serum levels of IL-18,IL-6 and NO between the treated group and the control group(P>0.05).Conclusion:IL-18,IL-6 and NO are important regulators of immune cytokines of TB infection.Serum levels of IL-18,IL-6 and NO are in direct proportion to multidrug resistant species,their serum levels can be the key indicators monitoring the disease activity and outcome of retreatment TB patients and they can predict the effectiveness of treatment program of retreatment tuberculosis.%目的：探讨复治肺结核患者血清白细胞介素-18(IL-18)、白细胞介素-6(IL-6)和一氧化氮(NO)表达水平改变情况及其意义。方法：选择深圳市宝安区中心医院2012年1月-2014年12月收治的复治肺结核患者120例为观察组，其中28例耐药为2种或2种以下者为低耐药组，45例耐药为3种或4种者为中耐药组，47例耐药多于4种者为高耐药组；经治疗后，治愈的66例患者为治愈组，未治愈的54例患者为未治愈组，同时选择正常健康人60例为对照组，分别空腹抽取静脉血，对不同组血清NO、IL-18及IL-6水平进行比较分析。结果：治疗前，观察组血清IL-18、IL-6及NO水平明显高于对照组，差异均有统计学意义(P<0.05)；血清IL-18、IL-6及NO水平由高到低分别为高耐药组>中耐药组>低耐药组，差异均有统计学意义(P<0.05)；治疗后，治愈组与未治愈组血清IL-18、IL-6及NO水平有所下降，治愈组低于未治愈组，差异均有统计学意义(P<0.05)，治愈组血清IL-18、IL-6及NO水平与对照组比较差异无统计学意义(P>0.05)。结论：IL-18、IL-6及NO均是抗结核感染免疫的重要调节细胞因子，血清IL-18、IL-6和NO水平与多耐药种类有关，其血清水平可作为监测复治肺结核病情活动和转归的重要指标，可以预知复治肺结核治疗方案的有效性。