Detection Of Cytokines In Pleural Effusion Of Patients With Type 2 Diabetes Mellitus Complicated With Pulmonary Tuberculosis And Its Clinical Significance

Objective To study the changes of tumor necrosis factor alpha(TNF-alpha), interferon gamma(IFN-gamma) and interleukin 18(IL-18) in type 2 diabetes mellitus complicated with pulmonary tuberculosis pleural effusion of patients.Methods The application of enzyme linked immunosorbent assay(ELISA) were measured in 58 cases of patients with type 2 diabetes mellitus complicated with pulmonary tuberculosis(combined group), 50 cases of pulmonary tuberculosis patients(tuberculosis group) and 45 patients with pleural effusion but neither had pulmonary tuberculosis nor diabetes(matched group) for pleural effusion of TNF- alpha, IFNgamma and IL-18, and then we compare with each other, analysis of its clinical significance.Results ①TNF-alpha, IFN-gamma and IL-18 levels in pleural effusion of combined group and tuberculosis group chest water were significantly higher than that of control group, P < 0.05, the difference is statistically significant. ②TNF- alpha and IFN- gamma levels in pleural effusion of merge patients were significantly higher than that in tuberculosis group, P < 0.05, the difference is statistically significant; but concerned with the level of IL-18 comparison, P > 0.05, there was no statistically significant difference.③In merging group,the level of pulmonary tuberculosis patients with type 2 diabetes ’s TNF-alpha and IFN-gamma in pleural effusion were significantly higher than that in patients with type 2 diabetes and tuberculosis,and we also found that the level in patients with type 2 diabetes and tuberculosis were higher than that in type 2 diabetespatients with pulmonary tuberculosis, the level in pulmonary tuberculosis patients with type 2 diabetes were higher than that in type 2 diabetespatients with pulmonary tuberculosis, P <0.05, the difference is statistically significant; But there was no statistically significant difference in the three sets of IL-18 level comparison. P>0.05. ④TNF-alpha, IFN-gamma and IL-18 levels in patients combined with high fever symptoms were higher than those without high fever symptoms, P <0.05, the difference is statistically significant. ⑤TNF-alpha,IFN-gamma and IL-18 levels in patients with positive sputum bacterium were higher than that of patients with negatie sputum bacterium, P<0.05, the difference is statistically significant. ⑥TNF-alpha, IFN-gamma and IL-18 levels in patients with miliary tuberculosis were higher than those with cavitary pulmonary tuberculosis, infiltrative pulmonary tuberculosis and tuberculous pleurisy, P<0.05, the difference is statistically significant; and the level in patients with cavitary pulmonary tuberculosis were higher than those with infiltrative pulmonary tuberculosis and tuberculous pleurisy, P <0.05, the difference is statistically significant; the level in patients with tuberculous pleurisy was the lowest in all, P<0.05, the difference is statistically significant.Conclusion ①The TNF-alpha, IFN-gamma levels in pleural effusion of patients with type 2 diabetes mellitus complicated with pulmonary tuberculosis were much higher than those in patients with pulmonary tuberculosis; ②The TNF-alpha, IFN-gamma and IL-18 levels in pleural effusion of the patients with type 2 diabetes mellitus complicated with pulmonary tuberculosis were closely related with pulmonary tuberculosis disease type,disease activity and clinical disease degree.