TGF-β、IFN-γ、IL-10与多药联合治疗肺结核产生耐药性和疗效的相关性探讨-东南大学学报医学版

TGF-β、IFN-γ、IL-10与多药联合治疗肺结核产生耐药性和疗效的相关性探讨

单位：孝感市中心医院(武汉科技大学附属医院) 感染科, 湖北孝感 432000

分类号：R521;R453

出版年·卷·期（页码）：2022·41·第一期（114-120）

摘要：

目的：探讨转化生长因子-β（TGF-β）、干扰素γ（IFN-γ）、白介素-10（IL-10）与多药联合治疗肺结核产生耐药性和疗效的相关性。方法：选取2018年6月至2020年6月我院165例肺结核患者，根据药敏试验结果分为耐多药组（n=44）、耐单药组（n=56）、非耐药组（n=65），比较各组TGF-β、IFN-γ、IL-10水平，采用受试者工作特征（ROC）曲线分析各指标诊断耐多药肺结核的价值，比较不同疗效患者一般资料以及血清TGF-β、IFN-γ、IL-10水平，采用多因素Logistic回归方程分析是否转阴的相关影响因素。结果：耐多药组血清TGF-β、IL-10水平高于耐单药组、非耐药组；耐单药组高于非耐药组，耐多药组血清IFN-γ水平低于耐单药组、非耐药组，耐单药组低于非耐药组（P<0.05）。血清TGF-β、IFN-γ、IL-10联合诊断耐多药肺结核的曲线下面积（AUC）为0.894，最佳诊断敏感度、特异度分别为88.64%、77.69%。转阴患者既往治疗过程有中断史者占比低于未转阴患者，治疗后血清TGF-β、IL-10水平低于未转阴患者，血清IFN-γ水平高于未转阴患者，转阴患者治疗前后差值绝对值高于未转阴者（P<0.05）；血清TGF-β、IFN-γ、IL-10与耐多药肺结核患者抗结核治疗转阴情况相关（P<0.05）。结论：血清TGF-β、IFN-γ、IL-10与多药联合治疗肺结核产生耐药性及疗效显著相关。

Objective: To explore the correlation of transforming growth factor-β(TGF-β), interferon-γ(IFN-γ), interleukin-10(IL-10) with multi-drug resistance and efficacy in the treatment of tuberculosis. Methods: 165 patients with tuberculosis in our hospital from June 2018 to June 2020 were selected and divided into multi-drug resistant group(n=44), single-drug resistant group(n=56), and non-drug resistant group(n=65) based on the results of the drug sensitivity test, the levels of TGF-β, IFN-γ, and IL-10 in each group were compared, receiver operating characteristic(ROC) curves were used to analyze the value of each index in the diagnosis of multidrug-resistant tuberculosis, the general data of patients with different curative effects, serum levels of TGF-β, IFN-γ and IL-10 were compared, multivariate Logistic regression equation was used to analyze the related affecting factors whether to turn negative. Results: Serum TGF-β and IL-10 levels in the multi-drug resistant group were higher than those in the single-drug resistant and non-drug resistant groups, the single-drug resistant group was higher than that in the non-drug resistant group; the serum IFN-γ level in the multi-drug resistant group was lower than those in the single-drug resistant group and the non-drug resistant group, and the level in the single-drug resistant group was lower than that in the non-drug resistant group(P<0.05). The area under the curve(AUC) of the serum TGF-β, IFN-γ, IL-10 combined diagnosis of multi-drug resistant pulmonary tuberculosis was 0.894, the best diagnostic sensitivity and specificity were 88.64% and 77.69%, respectively. The proportion of negative conversion patients with a history of interruption in the previous treatment process was lower than that of non-negative patients. After treatment, the serum TGF-β and IL-10 levels were lower than those of non-negative patients, and the serum IFN-γ levels were higher than those of non-negative patients and the absolute differences of negative conversion patients before and after treatment were higher than those of non-negative patients(P<0.05). The serum TGF-β, IFN-γ, and IL-10 were related to the negative status of anti-tuberculosis treatment in patients with multidrug-resistant pulmonary tuberculosis(P<0.05). Conclusion: Serum TGF-β, IFN-γ, IL-10 are significantly related to drug resistance and efficacy with multi-drug combination treatment of pulmonary tuberculosis.

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