结核性及恶性胸腔积液患者的Th1、Th2相关细胞因子的表达及分析

发布时间：2018-04-28 20:35

本文选题：细胞因子 + Th1/Th2　；参考：《宁波大学》2017年硕士论文

【摘要】：目的:探讨结核性胸腔积液和恶性胸腔积液患者免疫应答的特征,比较两者血清中细胞因子分布差异,为临床对结核性胸腔积液和恶性胸腔积液进行鉴别诊断提供理论依据。方法:以2014年10月至2016年10月在我院住院患者和健康体检者为研究对象,选择50例结核性胸膜炎患者、50例恶性胸腔积液患者以及30例健康体检者进行研究,分别作为结核组、肿瘤组和对照组。采用双抗体夹心酶联免疫吸附试验(ELISA)测定所有受试者胸腔积液和血清中白细胞介素-2(interleukin-2,IL-2)、γ-干扰素(Interferon-γ,IFN-γ)、白细胞介素-4(interleukin-4,IL-4)以及白细胞介素-10(interleukin-10,IL-10)水平。结果:1两组患者胸腔积液细胞因子水平的比较结核组胸腔积液中IL-2、IL-10及IFN-γ浓度水平均显著高于肿瘤组(P0.05);结核组的IFN-γ/IL-4显著高于肿瘤组(P0.05);结核组IL-4水平略高于肿瘤组,但两组相比差异无统计学意义(P0.05)。2三组受试者血清细胞因子水平的比较与对照组相比,结核组和肿瘤组IL-2、IL-4水平均显著高于对照组,IFN-γ/IL-4比值均显著低于对照组,差异均有统计学意义(P0.05);与结核组相比,肿瘤组IL-2、IL-10水平均显著低于结核组,IL-4水平显著高于结核组,IFN-γ/IL-4比值显著低于结核组(P0.05);三组受试者的IFN-γ水平相似,差异无统计学意义(P0.05)。3结核组胸腔积液与血清各细胞因子水平比较结核组胸腔积液中IL-2、IFN-γ、IL-4和IL-10水平均显著高于血清(P0.05),IFN-γ/IL-4比值亦显著高于血清(P0.05)。4肿瘤组胸腔积液与血清各细胞因子水平比较肿瘤组胸腔积液中IL-2、IFN-γ、IL-4水平均显著低于血清中的水平,IL-10水平显著高于血清中IL-10水平,差异均有统计学意义(P0.05);胸腔积液中IFN-γ/IL-4比值显著低于血清(P0.05)。结论:1结核胸腔积液患者以Th1免疫模式占优势,恶性胸腔积液患者T细胞免疫应答下调,以Th2免疫应答模式为主。2恶性胸腔积液局部Th1/Th2平衡受破坏,由Th1向Th2漂移,Th1型细胞因子有潜在的恶性胸腔积液免疫治疗作用;3联合测定胸腔积液中IL-2、IFN-γ水平有助于其性质、病因的初步判断;4血清IL-10水平的测定可用于初步鉴别胸腔积液的性质。
[Abstract]:Objective: to investigate the characteristics of immune response in patients with tuberculous pleural effusion and malignant pleural effusion, and to compare the distribution of cytokines in serum between them, and to provide a theoretical basis for the differential diagnosis of tuberculous pleural effusion and malignant pleural effusion. Methods: 50 patients with tuberculous pleurisy, 50 patients with malignant pleural effusion and 30 healthy people were selected as tuberculosis group from October 2014 to October 2016. Tumor group and control group. The levels of Interferon- 纬 -IFN- 纬, Interferon- 纬 -IFN- 纬, interleukin-10interleukin-10IL-10 and interleukin-10interleukin-10IL-10 in pleural effusion and serum of all subjects were measured by double antibody sandwich enzyme linked immunosorbent assay (ELISAA). Results the levels of cytokines in pleural effusion were significantly higher in tuberculous group than in tumor group, the levels of IFN- 纬 / IL-4 in tuberculous group were significantly higher than those in tumor group, the level of IL-4 in tuberculous group was slightly higher than that in tumor group, the level of IFN- 纬 -IL-4 in tuberculous group was higher than that in tumor group, and the level of IFN- 纬 -IL-4 in tuberculous group was slightly higher than that in tumor group. But there was no significant difference between the two groups. The levels of serum cytokines were significantly higher in tuberculosis group and tumor group than those in control group. The ratio of IFN- 纬 / IL-4 in tuberculosis group and tumor group was significantly lower than that in control group. The level of IL-10 in tumor group was significantly lower than that in tuberculosis group, and the ratio of IFN- 纬 / IL-4 in tumor group was significantly lower than that in tuberculosis group, and the IFN- 纬 / IL-4 ratio in three groups was similar, compared with that in tuberculosis group, the level of IL-10 in tumor group was significantly lower than that in tuberculosis group and the ratio of IFN- 纬 / IL-4 in tuberculosis group was significantly lower than that in tuberculosis group. No significant difference in levels of cytokines in pleural effusion and serum in tuberculous group; the levels of IL-4 and IL-10 in pleural effusion of tuberculous group were significantly higher than those in serum P0.05 and IFN- 纬 / IL-4 ratio, and the ratio of IFN- 纬 / IL-4 in serum P0.05.4 tumor group was significantly higher than that in serum P0.05.4 tumor group. The levels of cytokines in pleural effusion of tumor group were significantly lower than those in serum and IL-10 level was significantly higher than that in serum IL-10 level, and the level of IL-4 in pleural effusion of tumor group was significantly lower than that in serum. The ratio of IFN- 纬 / IL-4 in pleural effusion was significantly lower than that in serum. Conclusion the Th1 immune model is dominant in patients with tuberculous pleural effusion, T cell immune response is down-regulated in malignant pleural effusion patients, and the local Th1/Th2 balance in malignant pleural effusion is destroyed mainly by Th2 immune response mode. The shift of Th1 cytokines from Th1 to Th2 may play a potential role in immunotherapy of malignant pleural effusion. The combined determination of IL-2 and IFN- 纬 levels in pleural effusion may be helpful to its properties. The determination of serum IL-10 level can be used to identify the characteristics of pleural effusion.
【学位授予单位】：宁波大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R521.7;R730.43

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