摘要
目的探讨肺结核患者在抗结核治疗过程中炎症细胞因子对抗结核性药物肝损伤的预测作用。方法将初治肺结核患者随机分为护肝药干预组和空白对照组,用液相芯片技术检测抗结核治疗前、治疗2周后或发生药物性肝损伤时的血清中炎症细胞因子IL-4、IL-6、IL-8、IL-10、IL-1α、IL-1β、IFN-γ及肿瘤坏死因子-α(TNF-α)的变化。结果护肝药干预组及空白对照组的抗结核性药物肝损伤发生率分别为14.77%和15.56%,且两组发生药物性肝损伤时各炎症细胞因子血清浓度差异无统计学意义(P> 0.05)。在肝损伤组和非肝损伤组中,抗结核治疗后IFN-γ和IL-6的血清浓度均较治疗前明显下降,而IL-10较治疗前则明显升高,差异有统计学意义(P <0.05);炎症细胞因子IL-4仅在发生肝损伤时血清浓度下降并伴TNF-α的血清浓度升高,差异有统计学意义(P <0.05);IL-8、IL-1α和IL-1β在肝损伤组和非肝损伤组中治疗前后血清浓度均无明显变化(P> 0.05)。结论血清炎症细胞因子IL-4的降低伴TNF-α的升高对于抗结核性药物性肝损伤的发生具有预测意义。
Objective To explore the predictive role of inflammatory cytokines in hepatic injury during an tituberculosis treatment.Methods Untreated tuberculosis patients were randomly divided into liver protection drug intervention group and blank control group,and were collected the serum before treatment,treatment for 2 weeks or during drug-induced liver injury.The serum levels of IL-4,IL-6,IL-8,IL^-10,IL^-1α,IL^-1β,IFN-γand TNF-αwere detected by the liquid chip technology.Results Liver protection drug intervention group and blank control group of anti-tb drugs liver injury incidence were 14.77%and 15.56%respectively,and two groups of all cytokines has no difference when drug-induced liver injury occurs(P >0.05).In hepatic injury group and non liver injury group,IFN-γand IL-6 was significantly decreased while IL^-10 was significantly higher than before treatment(P<0.05).In addition,IL-4 decreased only during the occurrence of anti-tuberculous liver injury,ac companied by an increase of TNF-α,which was statistically significant(P<0.05).Other cytokines,IL-8、IL^-1αand IL^-1β,were not significantly changed before and after the treatment of hepatic injury group and non-hepatic in jury group(P >0.05).Conclusion The decrease of IL-4 accompanied by the increase of TNF-αis of significance for the occurrence of anti-tuberculous drug-induced liver injury.
作者
孟慧杰
杨雪迎
覃红娟
邝浩斌
李艳
黎燕琼
巫丽兰
谭守勇
MENG Huijie;YANG Xueying;QIN Hongjuan;KUANG Haobin;LI Yan;LI Yanqiong;WU Lilan;TAN Shouyong(Guangzhou Chest Hospital,Guangzhou 510095,China)
出处
《实用医学杂志》
CAS
北大核心
2019年第2期238-241,共4页
The Journal of Practical Medicine
基金
广州市科技计划项目(编号:155700012
201508020248)
广州市医药卫生科技项目(编号:20151A011038)
