【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；

【Author】 MENG Hui-jie;YANG Xue-ying;QIN Hong-juan;KUANG Hao-bin;LI Yan;LI Yan-qiong;WU Li-lan;TAN Shou-yong;Guangzhou medical university;

【机构】 广州市胸科医院；

【摘要】 目的探讨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。方法将未接受治疗的初治肺结核患者随机分成护肝药干预组和空白对照组,收集患者治疗前、治疗2周后或发生药物性肝损伤时的血清,用液相芯片技术检测炎症细胞因子IL-4、IL-6、IL-8、IL-10、IL-1α、IL-1β、IFN-γ、TNF-α的变化水平。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无明显差异(P>0.05)。在肝损伤组和非肝损伤组中,患者经抗结核治疗后IFN-γ和IL-6的血清浓度均较治疗前明显下降,而血清IL-10的水平较治疗前则明显升高,差异有统计学意义(P<0.05);而炎症细胞因子IL-4仅在发生抗结核药物性肝损伤时血清浓度下降,且同时伴有TNF-α血清浓度的升高,差异有统计学意义(P<0.05);其余细胞因子IL-8、IL-1α和IL-1β在肝损伤组和非肝损伤组治疗前后均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。更多还原

【Abstract】 Objective To explore the predictive role of inflaumatory cytokines in hepatic injury during antituberculosis treatment.Methods Untreated tuberculosis patients were randomly divided into liver protection drug intervention group and blank control group,and collected the serum before treatment,treatment for 2 weeks or drug-induced liver injury.Then detected the serum levels of IL-4,IL-6,IL-8,IL-10,IL-1α,IL-1β,IFN-γ and TNF-α 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 rug-induced liver injury occurs(P> 0.05).In hepatic injury group and non-liver injury group,IFN-γ and IL-6 was significantly decreased while IL-10 was significantly higher than before treatment.(P <0.05);In addition,11-4 decreased only during the occurrence of antituberculous liver injury,accompanied by an increase in TNF-α,which was statistically significant(P<0.05).Other cytokines like il-8,i1-1α and il-1βwere not significantly changed before and after the treatment of hepatic injury group and non-hepatic injury group(P> 0.05).Conclusion The decrease of Il-4 accompanied by the increase of TNF-α is of significance for the occurrence of antituberculous drug-induced liver injury.更多还原