Dynamic Changes And Clinical Value Of T Cells And Related Cytokines In Newly Treated Multidrug-Resistant Pulmonary Tuberculosis Patients

Objective:By analyzing the dynamic changes of T cells and related cytokines in newly treated patients with m DR-TB,the clinical value of T cells in the evaluation of disease efficacy was described,and the theoretical basis for guiding clinical application was provided.Methods:From October 2020 to October 2021,60 cases of m DR-TB diagnosed in Guiyang Public Health Treatment Center and 60 cases of healthy control group were collected.According to the anti-tuberculosis treatment status of MDR-TB patients,they were divided into good prognosis group and poor prognosis group.T lymphocyte count(CD4~+、CD8~+、CD4~+/CD8~+)was detected by flow cytology,and related cytokines(TNF-α,、IFN-γ、IL-10、IL-6)were detected by enzyme linked immunosorbent assay.The changes of T cells and related cytokines in THE MDR-TB group before and after treatment and in the MDR-TB group before and after treatment were analyzed retrospectively.SPSS 25.0 software was used to analyze and process the data.Independent sample T test was used for inter-group measurement to judge the difference.The paired sample T test was used for intra-group comparison to judge the difference.Chi-square test was used to judge the difference of classification variables.Univariate analysis was used to analyze the related factors affecting the prognosis of patients with drug-resistant tuberculosis,and multivariate Logistic regression analysis was used to analyze the independent risk factors for prognosis of patients with drug-resistant tuberculosis.ROC curve analysis was used to evaluate the clinical value of prognosis in patients with drug-resistant tuberculosis.P<0.05 was considered as statistically significant difference.Results:1.Before treatment,T cells(CD4~+、CD8~+、CD4~+/CD8~+)in MDR-TB group were lower than those in healthy control group,and related cytokines(IL-10,IL-6,TNF-A,IFN-Y)were higher than those in healthy control group,the differences were statistically significant(P<0.05).2.In the MDR-TB group,CD4~+、CD8~+、CD4~+/CD8~+were higher than before treatment,while TNF-α、IFN-γ、IL-10、IL-6were lower than before treatment,with statistical significance(P<0.05).CD4~+、CD8~+、CD4~+/CD8~+decreased further in the group with no significant curative effect.Il-6 and TNF-αwere higher than before treatment,the difference was statistically significant(P<0.05).There were no significant changes in IL-10 and IFN-γcompared with before treatment(P>0.05).CD4~+、CD8~+、CD4~+/CD8~+in the group with significant efficacy were higher than those in the group without significant efficacy,as shown in Table 7.TNF-αand IL-10in the group with significant therapeutic effect were lower than those in the group without significant therapeutic effect,the differences were statistically significant(P<0.05).There was no significant difference in IL-6 and IFN-γbetween the two groups(P>0.05).3.ROC analysis showed that CD4~+、CD8~+、CD4~+/CD8~+AUC values(0.892,0.694,0.717)were significant at 95%confidence level.Among them,the prediction effect of CD4~+index is better than other indexes.TNF-α、IFN-γ、IL-10and IL-6AUC values(0.835,0.642,0.583,0.457)were significant only at the 95%confidence level,indicating that TNF-αhad a better prediction effect than the other two indicators.After screening,CD8~+、CD4~+/CD8~+and TNF-αwere included in multifactor analysis,and the results showed that CD8~+and TNF-αwere independent risk factors affecting the efficacy of MDR-TB,and the difference was statistically significant(P<0.05).Conclusion:1.T cells(CD4~+、CD8~+、CD4~+/CD8~+)and cytokines(TNF-α、IFN-γ、IL-10、IL-6)were closely related to MDR-TB;2.T cells(CD4~+、CD8~+、CD4~+/CD8~+)were positively correlated with the efficacy of MDR-TB patients,and had a predictive effect on the efficacy of m DR-TB patients.Cytokines(TNF-α、IFN-γ、IL-10、IL-6)were negatively regulated with the efficacy of MDR-TB patients,among which TNF-α、IFN-γ、IL-10had a predictive effect on the efficacy of MDR-TB patients.CD8~+and TNF-αare independent risk factors affecting the efficacy of MDR-TB.Therefore,comparative analysis of the dynamic changes of T cells and related cytokines in MDR-TB patients is of great significance for the evaluation of the efficacy of the disease.