初治涂阳肺结核患者细胞因子变化及生命质量分析

发布时间：2018-03-08 17:29

本文选题：细胞因子　切入点：变化　出处：《中国公共卫生》2016年02期 　论文类型：期刊论文

【摘要】：目的了解初治涂阳肺结核患者的细胞因子变化和生命质量情况,分析其影响因素,为确定肺结核综合防治方案提供参考依据。方法整群抽取浙江省台州市第一人民医院和温岭市结核病防治所2012年6月—2014年5月收治的196例初治涂阳肺结核患者,检测抗结核治疗前和治疗后2个月干扰素γ、白介素2、白介素10和白介素18的水平,同时应用中文版健康调查简表(SF-36)评价其生命质量情况,并分析生命质量的影响因素。结果肺结核患者治疗2个月后干扰素γ和白介素2水平分别为(97.3±40.5)和(54.1±19.3)ng/L,均高于治疗前的(43.2±17.3)和(36.3±13.9)ng/L,白介素10和白介素18水平分别为(82.3±29.4)和(130.9±50.3)ng/L,均低于治疗前的(116.2±44.7)和(243.0±86.8)ng/L(均P0.05);治疗2个月后痰菌转阴患者的干扰素γ和白介素2水平分别为(109.8±35.4)和(58.1±18.7)ng/L,均高于痰菌未转阴患者的(50.4±16.3)和(39.0±13.3)ng/L,白介素10和白介素18水平分别为(77.3±24.2)和(107.6±33.6)ng/L,均低于痰菌未转阴患者的(102.4±32.9)和(221.3±69.2)ng/L(均P0.05);肺结核患者SF-36量表生理功能、生理职能、躯体疼痛、总体健康、活力、社会功能、情感职能、精神健康维度得分和生命质量总分分别为(70.14±23.07)、(45.32±21.69)、(67.42±18.26)、(61.28±26.34)、(49.32±16.85)、(57.64±12.46)、(64.71±11.31)、(52.83±20.47)和(512.25±132.57)分;多因素非条件logistic回归分析结果显示,年龄50岁、职业为农民、有债务负担和患慢性病的初治涂阳肺结核患者生命质量较低,文化程度初中及以上、年人均收入≥20 000元、有医保、治疗2个月后痰菌转阴和治疗3个月后病灶吸收的初治涂阳肺结核患者生命质量较高。结论初治涂阳肺结核患者抗结核治疗后细胞因子水平增高,但生命质量较低;年龄、文化程度、职业、年人均收入、有无医保、有无债务负担、是否患慢性病、治疗后痰菌是否转阴及病灶是否吸收是其生命质量的主要影响因素。
[Abstract]:Objective to investigate the changes of cytokines and quality of life (QOL) in patients with smear positive pulmonary tuberculosis, and to analyze the influencing factors. Methods A total of 196 cases of smear positive pulmonary tuberculosis were collected from the first people's Hospital of Taizhou City of Zhejiang Province and the Institute of Tuberculosis Control and Prevention of Wenling City from June 2012 to May 2014. The levels of interferon 纬, interleukin 2, interleukin 10 and interleukin 18 were measured before and 2 months after treatment, and the quality of life was evaluated by SF-36. Results the levels of interferon 纬 and interleukin 2 were 97.3 卤40.5) and 54.1 卤19.3 ng / L, respectively, which were higher than those before treatment (43.2 卤17.3) and 36.3 卤13.9 ngL / L, the levels of interleukin 10 and interleukin 18 were 82.3 卤29.4and 130.9 卤50.3ng / L, respectively. The levels of interferon 纬 and interleukin 2 in sputum negative patients were significantly lower than those before treatment (116.2 卤44.7) and 243.0 卤86.8 ng / L (all P 0.05; 109.8 卤35.4) and 58.1 卤18.7ng / L, respectively, which were higher than those in patients without negative sputum (50.4 卤16.3) and 39.0 卤13.3 ng / L, IL-10 and IL-18, respectively. 77.3 卤24.2) and 107.6 卤33.6 ng / L were lower than those of sputum negative patients (102.4 卤32.9) and 221.3 卤69.2 ng / L (all P 0.05); the physiological function of SF-36 scale in pulmonary tuberculosis patients was significantly lower than that in patients without sputum negative. The scores of physical function, physical pain, general health, vitality, social function, emotional function, mental health dimension and total quality of life were 70.14 卤23.07 and 67.42 卤18.266.34 respectively, the age of 50 years old was 50 years old, the age was 52.83 卤20.57 and 512.25 卤132.57), the age of the patients was 50 years old, the age of the patients was 52.83 卤20.57), and the scores of physical function, physical pain, general health, vitality, social function, emotional function, mental health dimension and total score of quality of life were 75.14 卤23.07 卤21.69, 67.42 卤18.26 and 69.32 卤16.855,54.71 卤11.31 卤52.83 卤20.47 and 512.25 卤132.57, respectively. The occupation is farmer, the quality of life of the newly cured smear positive tuberculosis patients with debt burden and chronic disease is low, the education level is junior middle school and above, the annual per capita income is more than 20,000 yuan, the medical insurance is available. The quality of life of patients with primary smear positive pulmonary tuberculosis after 2 months of treatment and 3 months of treatment with primary smear positive pulmonary tuberculosis was higher. Conclusion the level of cytokines in patients with primary smear positive pulmonary tuberculosis increased after anti-tuberculosis treatment, but the quality of life was lower. Education level, occupation, annual per capita income, medical insurance, debt burden, chronic disease, sputum bacteria conversion after treatment and focus absorption are the main influencing factors of its quality of life.
【作者单位】：台州市第一人民医院感染科;
【基金】：台州市科学技术资助项目(121ky10)
【分类号】：R521

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