关键词:

肺结核, 细胞因子, 表达水平变化, 治疗效果

Abstract:

Objective To analyze the efficacy of changes in serum cytokine expression levels in the evalu⁃ ation of pulmonary tuberculosis treatment effects. Methods The serums of pulmonary tuberculosis patients were collected before treatment and after 2⁃month treatment. The expression levels of interleukin（IL）⁃1β，IL⁃2，IL⁃4， IL⁃5，IL⁃6，IL⁃8，IL⁃10，IL⁃12P70，IL⁃17，tumor necrosis factor（TNF）⁃α，interferon（IFN）⁃γ and IFN⁃α were measured by flow cytometry. At the same time，the changes of the lesions were monitored by imaging. The treat⁃ ment was considered as ineffective if the lesions did not change or increased after 2⁃month treatment when com⁃ pared with before treatment，and as effective when the lesions disappeared. Receiver operating curve analysis was done to analyze the cut⁃off value of ratio（ratio of the concentration of each cytokine in serum after 2⁃month treat⁃ ment to that before treatment）and identify the boundary value and test power between the ineffective and effective treatment of pulmonary tuberculosis. After further connecting different cytokines in series or in parallel，the com⁃ bined test performance was analyzed. Results （1）There was no significant difference in age and gender betweenthe ineffective group and the effective group. Overall，the expression levels of IL⁃6 and IFN⁃ γ in the serums of tuberculosis patients after two⁃month treatment were significantly lower than those before treatment（P = 0.020，P = 0.023，respectively）. The expression level of IL⁃10 in the serums after two⁃month treatment was significantly higher than that before treatment（P = 0.011）. After two⁃month treatment，the expression level of IL⁃6 in the serums in the effective group was significantly lower than that before treatment（P = 0.033）.（2）The sensitivity of the ratio of TNF，IL⁃17，IL⁃1β，IL⁃4，IL⁃6，IFN⁃γ，IL⁃12P70，IFN⁃α and IL⁃8 in judging the ineffectiveness of pulmonary tuberculosis treatment was >80%，but the specificity was low. The specificity of the ratio of IL⁃5 and IL⁃10 in judging the ineffectiveness of treatment was >80%，but the sensitivity was low.（3）After combination of IFN⁃ γ，IL⁃17 and IFN⁃ α in series，the sensitivity of judging the ineffectiveness of treatment was 84.00%，the specificity was 70.97%，and the accuracy was 76.79%. After combining the IL⁃6 and IFN⁃α in series，the sensitivi⁃ ty，specificity，and accuracy of judging the ineffectiveness were 80.00% ，67.74% ，and 73.21% ，respectively. Conclusion Compared with before treatment ，the changes in the expression levels of some cytokines in the serums of pulmonary tuberculosis patients after 2⁃month treatment have the potential for monitoring the effect of anti⁃ tuberculosis treatment. 

Key words:

tuberculosis, cytokines, changes in expression level, therapeutic effect