抗结核药物性肝损伤血清细胞因子研究

Analysis of Serum Cytokines in Antituberculosis Drug-Induced Liver Injury

摘要: 目的：探讨外周血IFN-γ、TNF-α及IL-10细胞因子与抗结核药物性肝损伤(ATDILI)的相关性及诊断价值。方法：纳入2022年1月至2023年1月石河子大学第一附属医院住院及门诊部诊断为初治肺结核的患者。将2个月内发生抗结核药物性肝损伤(ATDILI)患者为观察组，将完成整个2个月强化期未发生肝损伤的肺结核患者为对照组。共收入观察组23例，对照组22例。用ELISA法检测所有患者治疗前、观察组发生药物性肝损伤时、对照组抗结核治疗2个月后的外周血清细胞因子水平。结果：抗结核治疗后，观察组患者与对照组相比，IFN-γ、TNF-α及IL-10细胞因子水平均与对照组有显著差异，差异有统计学意义(P < 0.05)。IFN-γ、TNF-α及IL-10细胞因子灵敏度为73.91%、52.17%、65.22%；特异度分别为95.45%、95.45%、81.81%。结论：抗结核治疗后，IFN-γ、TNF-α、IL-10细胞因子与ATDILI有一定的相关性，可能参与了ATDILI的发生发展过程，对诊断ATDILI有一定的价值。

Abstract: Objective: To analyze the diagnostic value of and the correlation between the IFN-γ, TNF-α, IL-10 cytokines of peripheral blood and the process of anti-tuberculosis drug induced liver injury (ATDILI). Methods: Patients diagnosed with newly diagnosed pulmonary tuberculosis in the inpa-tient and outpatient departments of the First Affiliated Hospital of Shihezi University Medical Col-lege from January 2022 to January 2023 were included. The patients with anti-tuberculosis drug-induced liver injury (ATDILI) within 2 months were selected as the observation group, and the patients with pulmonary tuberculosis who completed the whole 2-month intensive an-ti-tuberculosis process without liver injury were selected as the control group. There were 23 cases in observation group and 22 cases in control group. The peripheral blood immune cell levels of all patients were tested before treatment, during drug-induced liver injury in the observation group, and 2 months after anti-tuberculosis treatment in the control group measured by ELISA. Results: After anti-tuberculosis treatment, in the observation group, compared with the control group, IFN-γ, TNF-α, IL-10 cytokine levels were significantly higher than the control group, and the difference was statistically significant (P < 0.05). The sensitivity of IFN-γ, TNF-α and IL-10 was 73.91%, 52.17% and 65.22%; the specificity was 95.45%, 95.45% and 81.81%. Conclusion: After anti-tuberculosis treatment, IFN-γ, TNF-α, and IL-10 cytokines were related with ATDILI, which may participate in the development of ATDILI, and have certain value in the diagnosis of ATDILI.