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目的 探讨肺结核患者是否存在Th1/Th2反应失衡 ,以及与病情严重程度和治疗反应的关系。方法 对 10 0名健康对照和 12 4例未经治疗的菌阳肺结核患者检测血清IgE、IL 4和IFN γ ,比较两组间差异并分析其与病情严重程度、治疗后痰菌阴转情况及初复治的关系。结果 肺结核组血清IgE(1.0 4 8± 0 .4 96 )、IL 4 (0 .4 39± 0 .16 0 )显著高于健康对照组 (分别为 0 .86 7± 0 .2 89和 0 .4 2 1±0 0 2 4 ) ,而血清IFN γ(0 .2 13± 0 .0 17)显著低于健康对照组 (0 .2 2 4± 0 .0 0 5 )。病灶范围大或有空洞形成的患者血清IL 4显著高于病灶范围小的患者 ,复治患者IL 4和IFN γ显著低于初治患者。抗结核治疗 2个月后痰菌未转阴组与痰菌阴转组相比 ,前者治疗前血清IL 4较高而IFN γ较低。结论 未经治疗的肺结核患者存在Th1反应减弱 ,Th2反应增强 ,其中病灶范围大或有空洞形成的患者更为显著。而且Th1反应较弱者治疗效果较差。
Objective To investigate whether there is an imbalance of Th1 / Th2 response in patients with pulmonary tuberculosis, as well as the relationship between the severity of the disease and the response to treatment. Methods Serum levels of IgE, IL 4 and IFN γ were detected in 10 0 healthy controls and 12 4 untreated patients with positive bacilli and pulmonary tuberculosis. The differences between the two groups were analyzed and compared with the severity of the disease, the sputum negative conversion after treatment, Early rehabilitation of the relationship. Results The serum levels of IgE (1.04 8 ± 0.496) and IL 4 (0.399 ± 0.16 0) in the pulmonary tuberculosis group were significantly higher than those in the healthy control group (0.86 7 ± 0.298 and 0.89, respectively). 4 2 1 ± 0 0 2 4), while serum IFN γ (0.21 ± 0. 0 17) was significantly lower than that of healthy controls (0.22 ± 0.505). Serum levels of IL-4 in patients with large or empty lesions were significantly higher than those in patients with small lesions and IL 4 and IFN-γ in retreatment patients were significantly lower than those in untreated patients. After 2 months of anti-TB treatment, the sputum bacteria did not turn negative group compared with the sputum negative conversion group, the former serum IL 4 and IFN γ were lower before treatment. Conclusions Th1 response is weakened and Th2 response is enhanced in untreated pulmonary tuberculosis patients, especially in patients with large or empty lesions. And Th1 response to the weaker treatment less effective.