本文選題：結(jié)核病患者 + TNF-α��； 參考：《青海大學》2013年碩士論文

【摘要】：目的：通過觀察腫瘤壞死因子-a(tumor necrosis factor-a,TNF-a)、γ-干擾素(interferon-γ,IFN-γ)及白細胞介素-4(interleukin-4,IL-4)在不同結(jié)核病患者和健康對照者外周血清中表達的變化和規(guī)律，分析結(jié)核的發(fā)生、發(fā)展及預后與TNF-a、IFN-γ、IL-4的關系；通過測定IL-4T590C和TNF-a G308A的基因多態(tài)性分析其與青海藏族結(jié)核病易感性的關系。 方法：采用酶聯(lián)免疫吸附試驗（ELSIA）測定25例活動性結(jié)核病患者、25例非活動性初治結(jié)核患者、25例抗結(jié)核治療3月患者、25例健康對照者外周血清TNF-α、IL-4、IFN-γ水平；以聚合酶鏈-限制性片段長度多態(tài)法(PCR—RFLP)對25例藏族結(jié)核病患者、25例健康非藏族對照者的IL-4T590C和TNF-α G308A基因多態(tài)性分析,并進行方差分析和組內(nèi)兩兩比較的SNK分析。本研究病例來源于青海省傳染病醫(yī)院門診和住院確診病例，健康對照者來自于相同醫(yī)院同期體檢的健康正常人群25例； 結(jié)果：活動性結(jié)核病患者、非活動性初治結(jié)核患者、抗結(jié)核治療3月患者、健康對照組血清TNF-α分別為0.156±0.070ng/ml、0.082±0.031ng/ml、0.106±0.019ng/ml、(0.058±0.012)ng/ml，經(jīng)結(jié)核組內(nèi)兩兩比較及與健康對照者比較，差異均有統(tǒng)計學意義(P0.05)；活動性結(jié)核病患者、初治非活動性結(jié)核患者、抗結(jié)核治療3月患者IFN-γ為(0.008±0.002)ng/ml、(0.103±0.016)ng/ml、(0.152±0.038)ng/ml,健康對照組為(0.042±0.020)ng/ml，經(jīng)結(jié)核組內(nèi)兩兩比較及與健康對照者比較，差異均有統(tǒng)計學意義(P0.05)；活動性結(jié)核病患者、初治非活動性結(jié)核患者、抗結(jié)核治療3月組患者IL-4為(0.150±0.047)ng/ml、(0.074±0.023)ng/ml、(0.028±0.013)ng/ml,健康對照組為(0.025±0.008)ng/ml；與健康對照者比較，除抗結(jié)核治療3月組的IL-4的差異無統(tǒng)計學意義外，活動性結(jié)核組和初治非活動性結(jié)核組IL-4含量均有差異，差異均有統(tǒng)計學意義(P0.05)，而結(jié)核組內(nèi)兩兩比較IL-4含量差異均有統(tǒng)計學意義(P0.05)；IL-4T590C TT、CT和CC基因型在對照組中分別是56%、36%和8%，，而在藏族結(jié)核患者組中分別是64%、32%和4%。CC基因型在對照組及藏族結(jié)核患者組中，相對于TT和CT基因組表達較低，但是對照組和藏族結(jié)核患者組間并沒有明顯差異（P0.05）。經(jīng)過分析，C和T基因頻率在對照組中是0.74和0.26，而在藏族結(jié)核患者組中是0.80和0.20，兩組之間經(jīng)過比較，C和T基因頻率也無明顯差異（P0.05）；TNF-α G308AGG、GA和AA基因型在對照組中分別是64%、28%和8%，而在藏族結(jié)核患者組中分別是60%、28%和12%。AA基因型在對照組及結(jié)核患者組中，相對于GG和GA基因組表達較低，但是對照組和結(jié)核患者組間并沒有明顯差異（P0.05）。經(jīng)過分析，G和A基因頻率在對照組中是0.78和0.222，而在藏族結(jié)核患者組中是0.74和0.26，兩組之間經(jīng)過比較，G和A基因頻率也無明顯差異（P0.05）基因多態(tài)性在藏族結(jié)核患者和健康對照者無差異(P＞0.05)； 結(jié)論：結(jié)核病患者外周血清TNF-α、IFN-γ、IL-4的水平與結(jié)核病的發(fā)生與病情發(fā)展相關，因此檢測TNF-α、IFN-γ、IL-4對結(jié)核病情的發(fā)展及預后判斷有一定價值；而IL-4T590C和TNF-α G308A基因多態(tài)性與青海藏族結(jié)核的發(fā)生無明顯關系，推測IL-4T590C和TNF-α G308A基因多態(tài)性與青海藏族結(jié)核易感性無關。
[Abstract]:Objective: To observe the changes and regularities of the expression of -a (tumor necrosis factor-A, TNF-a), interferon (interferon- gamma, IFN- gamma) and interleukin -4 (interleukin-4, IL-4) in the peripheral serum of different tuberculosis patients and healthy controls, and to analyze the relationship between the occurrence, development and prognosis of the tuberculosis. The relationship between IL-4T590C and TNF-a G308A gene polymorphisms and susceptibility to tuberculosis in Qinghai was analyzed.
Methods: enzyme-linked immunosorbent assay (ELSIA) was used to determine 25 cases of active tuberculosis, 25 non active primary tuberculosis patients, 25 cases of anti tuberculosis treatment in March, 25 healthy controls, and peripheral serum TNF- alpha, IL-4, IFN- gamma level, and 25 cases of Tibetan tuberculosis patients with polymerase chain restriction fragment length polymorphism (PCR RFLP), 25 The IL-4T590C and TNF- alpha G308A gene polymorphisms of healthy non Tibetan controls were analyzed, and the variance analysis and the SNK analysis of 22 in the group were compared. The cases were derived from the outpatient and hospitalized cases of the infectious disease hospital in Qinghai Province, and the healthy controls were from the normal healthy population of 25 cases in the same hospital in the same hospital.
Results: the serum TNF- alpha was 0.156 + 0.070ng/ml, 0.082 + 0.031ng/ml, 0.106 + 0.019ng/ml and (0.058 + 0.012) ng/ml in the healthy control group. The difference was statistically significant (P0.05) in the tuberculosis group (P0.05). In the patients with non active tuberculosis, IFN- gamma was (0.008 + 0.002) ng/ml, (0.103 + 0.016) ng/ml, (0.152 + 0.038) ng/ml, and healthy control group (0.042 + 0.020) ng/ml. The difference was statistically significant (P0.05) compared with healthy controls (P0.05); active tuberculosis patients, In the early treatment of non active tuberculosis patients, the IL-4 in the anti tuberculosis treatment group was (0.150 + 0.047) ng/ml, (0.074 + 0.023) ng/ml, (0.028 + 0.013) ng/ml, and the healthy control group was (0.025 + 0.008) ng/ml. Compared with the healthy controls, there was no statistical difference between the anti tuberculosis treatment group and the March group, the active tuberculosis group and the initial non active tuberculosis. There were significant differences in IL-4 content in group IL-4, but there were significant differences in IL-4 content in the tuberculosis group (P0.05), IL-4T590C TT, CT and CC genotypes were 56%, 36% and 8% in the control group, while 64%, 32% and 4%.CC in the Tibetan tuberculosis patients were in the control group and the Tibetan tuberculosis patients. In the group, the expression of the genome relative to TT and CT was low, but there was no significant difference between the control group and the Tibetan tuberculosis patients (P0.05). After analysis, the frequency of C and T gene was 0.74 and 0.26 in the control group, but 0.80 and 0.20 in the Tibetan tuberculosis group, and there was no significant difference between the C and T gene frequencies between the two groups (P0.05); TNF- alpha G. 308AGG, GA and AA genotypes were 64%, 28%, and 8% in the control group, while the 60%, 28% and 12%.AA genotypes in the Tibetan tuberculosis group were lower than the GG and GA genomes in the control and tuberculosis patients, but there was no significant difference between the control group and the tuberculosis group (P0.05). The frequencies of G and A genes were analyzed. There were 0.78 and 0.222 in the group, and 0.74 and 0.26 in the Tibetan tuberculosis patients. There was no significant difference in G and A gene frequencies between the two groups. There was no difference between the Tibetan tuberculosis patients and the healthy controls (P > 0.05).
Conclusion: the level of TNF- alpha, IFN- gamma, IL-4 in the peripheral serum of tuberculosis patients is related to the development of tuberculosis and the development of the disease. Therefore, the detection of TNF- alpha, IFN- gamma, IL-4 is of certain value to the development and prognosis of tuberculosis, while IL-4T590C and TNF- alpha G308A gene polymorphism is not related to the occurrence of Tibetan tuberculosis in Qinghai. It is speculated that IL-4T590C and TNF- alpha G308A gene polymorphism is not associated with tuberculosis susceptibility in Qinghai Tibetan population.
【學位授予單位】：青海大學
【學位級別】：碩士
【學位授予年份】：2013
【分類號】：R52

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