本文選題：細(xì)胞因子 + Th1/Th2�。� 參考：《寧波大學(xué)》2017年碩士論文

【摘要】：目的:探討結(jié)核性胸腔積液和惡性胸腔積液患者免疫應(yīng)答的特征,比較兩者血清中細(xì)胞因子分布差異,為臨床對結(jié)核性胸腔積液和惡性胸腔積液進(jìn)行鑒別診斷提供理論依據(jù)。方法:以2014年10月至2016年10月在我院住院患者和健康體檢者為研究對象,選擇50例結(jié)核性胸膜炎患者、50例惡性胸腔積液患者以及30例健康體檢者進(jìn)行研究,分別作為結(jié)核組、腫瘤組和對照組。采用雙抗體夾心酶聯(lián)免疫吸附試驗(yàn)(ELISA)測定所有受試者胸腔積液和血清中白細(xì)胞介素-2(interleukin-2,IL-2)、γ-干擾素(Interferon-γ,IFN-γ)、白細(xì)胞介素-4(interleukin-4,IL-4)以及白細(xì)胞介素-10(interleukin-10,IL-10)水平。結(jié)果:1兩組患者胸腔積液細(xì)胞因子水平的比較結(jié)核組胸腔積液中IL-2、IL-10及IFN-γ濃度水平均顯著高于腫瘤組(P0.05);結(jié)核組的IFN-γ/IL-4顯著高于腫瘤組(P0.05);結(jié)核組IL-4水平略高于腫瘤組,但兩組相比差異無統(tǒng)計(jì)學(xué)意義(P0.05)。2三組受試者血清細(xì)胞因子水平的比較與對照組相比,結(jié)核組和腫瘤組IL-2、IL-4水平均顯著高于對照組,IFN-γ/IL-4比值均顯著低于對照組,差異均有統(tǒng)計(jì)學(xué)意義(P0.05);與結(jié)核組相比,腫瘤組IL-2、IL-10水平均顯著低于結(jié)核組,IL-4水平顯著高于結(jié)核組,IFN-γ/IL-4比值顯著低于結(jié)核組(P0.05);三組受試者的IFN-γ水平相似,差異無統(tǒng)計(jì)學(xué)意義(P0.05)。3結(jié)核組胸腔積液與血清各細(xì)胞因子水平比較結(jié)核組胸腔積液中IL-2、IFN-γ、IL-4和IL-10水平均顯著高于血清(P0.05),IFN-γ/IL-4比值亦顯著高于血清(P0.05)。4腫瘤組胸腔積液與血清各細(xì)胞因子水平比較腫瘤組胸腔積液中IL-2、IFN-γ、IL-4水平均顯著低于血清中的水平,IL-10水平顯著高于血清中IL-10水平,差異均有統(tǒng)計(jì)學(xué)意義(P0.05);胸腔積液中IFN-γ/IL-4比值顯著低于血清(P0.05)。結(jié)論:1結(jié)核胸腔積液患者以Th1免疫模式占優(yōu)勢,惡性胸腔積液患者T細(xì)胞免疫應(yīng)答下調(diào),以Th2免疫應(yīng)答模式為主。2惡性胸腔積液局部Th1/Th2平衡受破壞,由Th1向Th2漂移,Th1型細(xì)胞因子有潛在的惡性胸腔積液免疫治療作用;3聯(lián)合測定胸腔積液中IL-2、IFN-γ水平有助于其性質(zhì)、病因的初步判斷;4血清IL-10水平的測定可用于初步鑒別胸腔積液的性質(zhì)。
[Abstract]:Objective: to investigate the characteristics of immune response in patients with tuberculous pleural effusion and malignant pleural effusion, and to compare the distribution of cytokines in serum between them, and to provide a theoretical basis for the differential diagnosis of tuberculous pleural effusion and malignant pleural effusion. Methods: 50 patients with tuberculous pleurisy, 50 patients with malignant pleural effusion and 30 healthy people were selected as tuberculosis group from October 2014 to October 2016. Tumor group and control group. The levels of Interferon- 緯 -IFN- 緯, Interferon- 緯 -IFN- 緯, interleukin-10interleukin-10IL-10 and interleukin-10interleukin-10IL-10 in pleural effusion and serum of all subjects were measured by double antibody sandwich enzyme linked immunosorbent assay (ELISAA). Results the levels of cytokines in pleural effusion were significantly higher in tuberculous group than in tumor group, the levels of IFN- 緯 / IL-4 in tuberculous group were significantly higher than those in tumor group, the level of IL-4 in tuberculous group was slightly higher than that in tumor group, the level of IFN- 緯 -IL-4 in tuberculous group was higher than that in tumor group, and the level of IFN- 緯 -IL-4 in tuberculous group was slightly higher than that in tumor group. But there was no significant difference between the two groups. The levels of serum cytokines were significantly higher in tuberculosis group and tumor group than those in control group. The ratio of IFN- 緯 / IL-4 in tuberculosis group and tumor group was significantly lower than that in control group. The level of IL-10 in tumor group was significantly lower than that in tuberculosis group, and the ratio of IFN- 緯 / IL-4 in tumor group was significantly lower than that in tuberculosis group, and the IFN- 緯 / IL-4 ratio in three groups was similar, compared with that in tuberculosis group, the level of IL-10 in tumor group was significantly lower than that in tuberculosis group and the ratio of IFN- 緯 / IL-4 in tuberculosis group was significantly lower than that in tuberculosis group. No significant difference in levels of cytokines in pleural effusion and serum in tuberculous group; the levels of IL-4 and IL-10 in pleural effusion of tuberculous group were significantly higher than those in serum P0.05 and IFN- 緯 / IL-4 ratio, and the ratio of IFN- 緯 / IL-4 in serum P0.05.4 tumor group was significantly higher than that in serum P0.05.4 tumor group. The levels of cytokines in pleural effusion of tumor group were significantly lower than those in serum and IL-10 level was significantly higher than that in serum IL-10 level, and the level of IL-4 in pleural effusion of tumor group was significantly lower than that in serum. The ratio of IFN- 緯 / IL-4 in pleural effusion was significantly lower than that in serum. Conclusion the Th1 immune model is dominant in patients with tuberculous pleural effusion, T cell immune response is down-regulated in malignant pleural effusion patients, and the local Th1/Th2 balance in malignant pleural effusion is destroyed mainly by Th2 immune response mode. The shift of Th1 cytokines from Th1 to Th2 may play a potential role in immunotherapy of malignant pleural effusion. The combined determination of IL-2 and IFN- 緯 levels in pleural effusion may be helpful to its properties. The determination of serum IL-10 level can be used to identify the characteristics of pleural effusion.
【學(xué)位授予單位】：寧波大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R521.7;R730.43

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