摘要
目的观察老年活动性肺结核患者血清25-羟维生素D3[25-(OH)D3]和炎症因子水平的变化,并探讨其临床意义。方法选择2018年1月至2019年7月在咸阳市中心医院感染科接受治疗的70例老年肺结核患者作为研究对象,按照疾病情况分为活动性肺结核组40例与非活动性肺结核组30例,选择同期在本院进行常规体检的30例健康志愿者作为对照组。检测并比较三组受检者的肿瘤坏死因子α(TNF-α)、白细胞介素-6(IL-6)、白细胞介素-8(IL-8)、内皮素-1(ET-1)水平和25-(OH)D3水平。结果活动性肺结核组患者的TNF-α、IL-6、IL-8、ET-1水平分别为(35.43±6.71)ng/L、(142.36±25.44)ng/L、(23.24±6.53)ng/L、(67.53±14.63)ng/L,明显高于非活动性肺结核组的(13.85±4.63)ng/L、(89.16±18.25)ng/L、(10.32±2.48)ng/L、(46.14±10.93)ng/L和对照组的(5.73±1.13)ng/L、(56.43±13.16)ng/L、(2.65±0.58)ng/L、(28.39±5.77)ng/L,25-(OH)D3水平为(42.27±12.94)ng/mL,明显低于非活动性肺结核组的(56.08±15.83)ng/mL和对照组的(80.31±8.79)ng/mL,差异均有统计学意义(P<0.05),而非活动性肺结核组患者的TNF-α、IL-6、IL-8、ET-1水平明显高于对照组,25-(OH)D3水平明显低于对照组,差异均有统计学意义(P<0.05);空洞型肺结核患者的血浆TNF-α、IL-6、IL-8、ET-1水平与非空洞型肺结核比较差异均无统计学意义(P>0.05);空洞型肺结核患者的支气管灌洗液TNF-α、IL-6、IL-8、ET-1水平分别为(278.54±7.40)ng/L、(574.14±28.13)ng/L、(315.62±8.28)ng/L、(91.69±15.87)ng/L,明显高于非空洞型肺结核患者的(42.84±7.28)ng/L、(146.67±26.58)ng/L、(20.37±6.16)ng/L、(65.50±14.82)ng/L,差异均有统计学意义(P<0.05);并发症患者的支气管灌洗液TNF-α、IL-6、ET-1水平分别为(30.90±6.54)ng/L、(41.76±7.19)ng/L、(84.73±15.60)ng/L,明显高于无并发症患者的(20.78±7.05)ng/L、(33.37±6.53)ng/L、(61.96±12.83)ng/L,差异均有统计学意义(P<0.05)。结论25-(OH)D3、TNF-α、IL-6、IL-8、ET-1可以作为判断老年性肺结核病情变化的有效指标,也是评估患者预后的较为重要指标。
Objective To observe the changes of serum 25 hydroxyvitamin D3(25-(OH)D3)and inflammatory factors in elderly patients with active pulmonary tuberculosis,and to explore their clinical significance.Methods A total of 70 elderly patients with pulmonary tuberculosis,who admitted to Department of Infectious Diseases,Xianyang Central Hospital from January 2018 to July 2019,were selected as the research objects.According to the disease situation,they were divided into active tuberculosis group(n=40)and inactive tuberculosis group(n=30).Thirty healthy volunteers who underwent routine physical examination in our hospital during the same period were selected as the control group.The levels of tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),interleukin-8(IL-8),endothelin-1(ET-1)and 25-(OH)D3 levels were detected and compared among the three groups.Results The levels of TNF-α,IL-6,IL-8,and ET-1 in patients with active pulmonary tuberculosis group were(35.43±6.71)ng/L,(142.36±25.44)ng/L,(23.24±6.53)ng/L,(67.53±14.63)ng/L,which were significantly higher than corresponding(13.85±4.63)ng/L,(89.16±18.25)ng/L,(10.32±2.48)ng/L,(46.14±10.93)ng/L of the inactive tuberculosis group,and corresponding(5.73±1.13)ng/L,(56.43±13.16)ng/L,(2.65±0.58)ng/L,(28.39±5.77)ng/L of the control group.25-(OH)D3 level was(42.27±12.94)ng/ML,which was significantly lower than(56.08±15.83)ng/mL in inactive pulmonary tuberculosis group and(80.31±8.79)ng/mL in control group(all P<0.05).TNF-α,IL-6,IL-8,ET-1 levels in inactive pulmonary tuberculosis group were significantly higher than those in the control group,and 25-(OH)D3 level was significantly lower than that in control group(P<0.05);the plasma levels of TNF-α,IL-6,IL-8,and ET-1 in the cavity group were not significantly different from those in the non-cavity group(all P>0.05);the levels of TNF-α,IL-6,IL-8,and ET-1 in bronchoalveolar lavage fluid of patients with cavitary pulmonary tuberculosis were(278.54±7.40)ng/L,(574.14±28.13)ng/L,(315.62±8.28)ng/L,(91.69±15.87)ng/L,respectively,which were significantly higher than corresponding(42.84±7.28)ng/L,(146.67±26.58)ng/L,(20.37±6.16)ng/L,(65.50±14.82)ng/L in patients with non-cavitary pulmonary tuberculosis(all P<0.05).The levels of TNF-α,IL-6 and ET-1 in bronchoalveolar lavage fluid of patients with complications were(30.90±6.54)ng/L,(41.76±7.19)ng/L,(84.73±15.60)ng/L,respectively,which were significantly higher than corresponding(20.78±7.05)ng/L,(33.37±6.53)ng/L,(61.96±12.83)ng/L of patients without complications(all P<0.05).Conclusion 25-(OH)D3,TNF-α,IL-6,IL-8,ET-1 can be used as effective indicators to judge the changes of pulmonary tuberculosis in elderly patients,and also an important indicator to evaluate the prognosis of patients.
作者
李海军
刘瑜
寇夕
LI Hai-jun;LIU Yu;KOU Xi(Department of Geriatrics,Xianyang Central Hospital,Xianyang 712000,Shaanxi,CHINA;Department of Infectious Diseases,Xianyang Central Hospital,Xianyang 712000,Shaanxi,CHINA)
出处
《海南医学》
CAS
2020年第22期2889-2892,共4页
Hainan Medical Journal
关键词
老年活动性肺结核
25-羟维生素D3
肿瘤坏死因子Α
白细胞介素-6
白细胞介素-8
临床意义
Elderly active pulmonary tuberculosis
25 hydroxyvitamin D3(25-(OH)D3)
Tumor necrosis factorα(TNF-α)
Interleukin-6(IL-6)
Interleukin-8(IL-8)
Clinical significance
