摘要
目的探讨肺结核患者血清骨桥蛋白(OPN)、白介素18(IL-18)、干扰素-γ(IFN-γ)和超敏C-反应蛋白(hs-CRP)水平的变化及其临床意义。方法选择初治的肺结核患者42例作为肺结核组,健康体检者36例作为对照组,应用酶联免疫吸附法(ELISA)测定血清OPN、IL-18、IFN-γ水平,免疫比浊法测定血清hs-CRP水平。比较肺结核组与对照组、伴有高热者和非高热者、痰菌阳性患者与阴性患者、病变程度严重患者与病情较轻患者OPN、IL-18、IFN-γ和hs-CRP水平。结果肺结核患者组血清OPN、IL-18、IFN-γ和hs-CRP水平明显高于对照组〔分别为(683.21±321.76)ng/ml vs.(168.46±117.31)ng/ml、(428.36±178.54)pg/ml vs.(157.32±83.45)pg/ml、(4.26±2.39)pg/ml vs.(0.17±0.36)pg/ml和(39.67±21.48)μg/ml vs.(3.23±1.34)μg/ml〕,差异均有统计学意义(P<0.05)。伴有高热(体温>39.0℃)患者血清OPN、IL-18、IFN-γ和hs-CRP水平明显高于非高热者〔分别为(743.66±364.23)ng/ml vs.(389.47±164.50)ng/ml、(456.32±261.41)pg/mlvs.(316.35±126.04)pg/ml、(4.67±3.21)pg/ml vs.(2.59±1.98)pg/ml和(51.24±21.62)μg/ml vs.(38.87±14.37)μg/ml〕,差异均有统计学意义(P<0.05);痰菌阳性的患者血清OPN、IL-18和IFN-γ水平明显高于痰菌阴性者〔分别为(612.48±340.33)ng/ml vs.(426.24±154.31)ng/ml、(436.76±211.78)pg/ml vs.(302.34±114.67)pg/ml和(3.81±2.01)pg/ml vs.(2.32±1.61)pg/ml〕,差异均有统计学意义(P<0.05)。病变程度严重的粟粒性肺结核、空洞性肺结核患者血清OPN〔(983.48±431.24)ng/ml、(778.65±214.69)ng/ml〕、IL-18〔(576.26±217.63)pg/ml、(414.57±194.35)pg/ml〕、IFN-γ〔(6.18±2.93)pg/ml、(5.07±2.34)pg/ml〕水平明显高于浸润性肺结核和结核性胸膜炎患者,差异均有统计学意义(P<0.05)。结论肺结核患者血清OPN、IL-18、IFN-γ和hs-CRP水平明显升高,OPN和IL-18可作为判断肺结核病变活动性和病情严重性的敏感指标。
Objective To investigate the levels of osteopontin（OPN）,interleukin-18（IL-18）,interferon-gamma（IFN-γ） and high sensitivity C reaction protein（hs-CRP） in the serum samples of patients with pulmonary tuberculosis（TB）.Methods Totally 42 TB patients and 36 normal controls in our hospital were enrolled in the study.Enzyme-linked immunosorbent assay（ELISA） was used to determine the levels of OPN,IL-18 and IFN-γ,and Immunoturbidimetric assay for serum hs-CRP level.Results Serum levels of OPN,IL-18,IFN-γ and hs-CRP in TB patients were significantly higher than those in the controls（P0.05）.Serum levels of OPN,IL-18,IFN-γ and hs-CRP in patients with high fever（body temperature39.0℃） were significantly higher than in those with normal body temperature（P0.05）.Serum levels of OPN,IL-18 and IFN-γ in patients positive for sputum smear were significantly higher than those in patients negative（P0.05）.Serum levels of OPN and IL-18 in patients with severe miliary TB or cavitary TB were significantly higher than those in infiltrative TB and tuberculous pleuritis（P0.05）.Conclusion OPN and IL-18 can be sensitive indicators for TB activity and severity.
出处
《中国全科医学》
CAS
CSCD
北大核心
2012年第31期3617-3619,共3页
Chinese General Practice
