新发传染病电子杂志2025，Vol.10Issue(3)：6-11,6.DOI:10.19871/j.cnki.xfcrbzz.2025.03.002
不同程度肺部受累的单纯肺结核患者免疫内分泌失衡特征分析
Characteristics of immune-endocrine imbalance in uncomplicated pulmonary tuberculosis patients with different degrees of lung involvement
摘要
Abstract
Objective To analyze the differential expression of immune endocrine mediators in patients with pulmonary tuberculosis(PTB)with different degrees of lung involvement,and evaluate the relationship between immune endocrine mediators and in vitro immune response.Method From January 2021 to November 2023,130 newly diagnosed adult PTB patients aged 18 to 65 years were enrolled in the PTB group,and 130 volunteers were recruited as the control group.All patients were classified into mild,moderate,and severe lung involvement according to the extent and type of radiological lesions.Blood samples were collected from all participants at 8:00 AM upon enrollment to measure their plasma levels of leptin,interleukin-6(IL-6),cortisol,dehydroepiandrosterone(DHEA),and C-reactive protein(CRP),and to analyze their in vitro immune responses,including lymphocyte proliferation and interferon-γ(IFN-γ)production.Result The levels of leptin and DHEA in the PTB group were lower than those in the control group,CRP,IL-6,Cortisol levels and cortisol/DHEA ratio were higher than those in the control group(P＜0.001).Further pairwise comparisons showed that the severe subgroup had lower leptin levels than the mild and moderate subgroups,lower DHEA levels than the mild subgroup,higher CRP,IL-6 and cortisol/DHEA levels than the mild and moderate subgroups,and higher cortisol levels than the mild subgroup(P＜0.001).Body mass index(BMI)was positively correlated with leptin in PTB group.Two discriminant functions of lung involvement in PTB patients were established by discriminant analysis of BMI and immunoendocrine mediators.There were significant differences in in vitro Mycobacterium tuberculosis-induced lymphocyte proliferation and IFN-γ production between control group and PTB group,especially in PTB patients with severe lung involvement,lymphocyte proliferation and IFN-γ production were significantly lower,and IFN-γ in the culture supernatant of leptin and PTB patients was positively correlated with concanavalin A-induced lymphocyte proliferation.Discriminant function 1 could explain 90.00%of the variance variation,while discriminant function 2 was only 10.00%.Both discriminant functions had significance difference(P＜0.001),and the group centroid of discriminant functions did not overlap.The degree of lung involvement in PTB patients can be clearly distinguished.Conclusion There is immune-endocrine imbalance in patients with PTB,which may lead to increased lung involvement.关键词
肺结核/免疫/内分泌/肺部受累Key words
Pulmonary tuberculosis/Immune/Endocrine/Lung involvement分类
医药卫生引用本文复制引用
张权武,王婉如,卢琼,辛超..不同程度肺部受累的单纯肺结核患者免疫内分泌失衡特征分析[J].新发传染病电子杂志,2025,10(3):6-11,6.基金项目
陕西省重点研发计划项目(2020SF-105) （2020SF-105）
