TNF-α和IFN-γ与T-SPOT.TB相结合应用于鉴别结核现症感染与隐性感染
Combined Application of TNF-α,IFN-γ and T-SPOT.TB in Identification between Active Tuberculosis Infection and Latent Tuberculosis Infection
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摘要: 目的 评价细胞因子IL-2、IL-4、IL-6、IL-10、TNF-α和IFN-γ在结核患者,隐性感染者及健康者中的水平.以期找到能够区分结核现症感染,隐性感染的细胞因子指标,为临床诊断结核提供新的依据.方法采用流式微球阵列法(CBA)检测60例T细胞斑点试验阳性的肺结核患者,55例T细胞斑点试验阳性的隐性感染者,30例T细胞斑点试验阴性的健康者的6种细胞因子(IL-2、IL-4、IL-6、IL-10、TNF-α和IFN-γ)的水平.结果 结核病(菌阳)组的IL-2、IL-6、TNF-α、IFN-γ水平均升高.血清IL-10水平各组间差异有统计学意义(P<0.05),且结核杆菌活动性及病情严重程度逐渐增加.结核患者的TNF-α、IFN-γ较正常人、结核杆菌隐性感染者升高.血清IL-4水平无差异(P>0.05).结论 与T-SPOT.TB法结合,TNF-α、IFN-γ可在细胞因子水平区分结核现症感染与隐性感染,对辅助鉴别诊断结核现症感染和隐性感染有重要的意义.Abstract: Objective To find cytokine index which can make a identification between active tuberculosis infection and latent tuberculosis infection and provide new evidence for tuberculosis diagnosis,we evaluated the levels of IL-2,IL-4,IL-6,IL-10,TNF-α and IFN-γ in people with active tuberculosis,latent tuberculosis infected people and normal people. Methods We detected the serum levels of six cytokines(IL-2, IL-4,IL-6, IL-10, TNF-α and IFN-γ) of 60 tuberculosis cases with T-SPOT.TB(+), 55 cases with latent tuberculosis infection and T-SPOT.TB(+),30 cases of normal people with T-SPOT.TB(-) by cytometric bead array(CBA). Results Compared with other groups, the levels of IL-2, IL-6, TNF-α and IFN-γ of tuberculosis(sputum culture positive) group were significantly increased(P<0.05). About IL-10,there were significant differences between two groups and the levels of IL-10 increased along with the increasing activity of tubercle bacillus and the severity of tuberculosis. TNF-α and IFN-γ of two tuberculosis groups were significantly higher than latent tuberculosis infected group and normal group(P<0.05).The serum levels of IL-4 showed no significant difference between different groups(P >0.05). Conclusions Combined with T-SPOT.TB, the detection of TNF-α and IFN-γ can make a identification between active tuberculosis infection and latent tuberculosis infection at the cytokine level, which is of great importance for the diagnosis and differentiation of latent tuberculosis infection.
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Key words:
- Cytokine /
- Tuberculosis /
- Latent infection /
- Diagnosis
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