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目的对糖尿病并发肺结核患者血清中的肿瘤坏死因子-α(TNF-α)、干扰素-γ(IFN-γ)、白细胞介素(IL)-6及IL-37的表达情况进行分析并探究其临床意义.方法 采用数字表法随机选取2015年6月至2016年12月之间本院患有糖尿病及肺结核的患者,分为3个组(每组40例):分别为糖尿病组(实验1组)、肺结核组(实验2组)、糖尿病并发肺结核组(实验3组);再采用数字表法随机选取健康志愿者作为对照组(40名).利用酶联免疫吸附试验对上述4组人群血清中的TNF-α、IFN-γ、IL-6及IL-37的表达情况进行分析比较.结果 实验1、2、3组患者的TNF-α、IFN-γ、IL-6及IL-37在外周血血清中的表达水平[实验1组分别为(0.39±0.11)、(0.23±0.09)、(11.20±4.32)、(6.64±2.99) g/L;实验2组分别为(0.65±0.13)、(0.27±0.08)、(17.80±4.10)、(8.75±3.52) g/L;实验3组分别为(0.99±0.14)、(0.38±0.07)、(25.80±5.29)、(9.87±3.95) g/L]的检测水平均明显高于对照组[分别为(0.27±0.12)、(0.20±0.05)、(5.71±3.97)、(4.32±2.18) g/L](实验1组与对照组比较,t值分别为20.785、0.367、27.659、3.984.除IFN-γ以外,P值均<0.05;实验2组与对照组比较,t值分别为65.818、1.039、13.682、5.440,P值均<0.05;实验3组与对照组比较,t值分别为115.997、2.736、18.849、5.292,P值均<0.05);且病情越重细胞因子水平越高,即实验3组的4个细胞因子水平均明显高于实验1、2组患者(实验1组与实验3组比较,t值分别为-51.961、-8.544、-14.977、-6.158,P值均<0.05;实验2组与对照组比较,t值分别为65.818、1.039、13.682、5.440,P值均<0.05),而实验2组的4个细胞因子水平均高于实验1组(实验1组与实验2组比较,t值分别为-22.517、-5.081、-28.844、-7.938,P值均<0.05);在实验3组患者中,有空洞者的IL-37水平为(10.85±4.19) g/L,明显高于无空洞者[(4.98±2.38) g/L](t=9.124,P<0.05).结论 TNF-α、IFN-γ、IL-6及IL-37的水平变化与糖尿病并发肺结核患者的免疫反应有密切的相关性,这4种细胞因子表达水平的高低与病情相关.“,”Objective To analyze and explore the clinical significance of TNF-α, IFN-γ, IL-6 and IL-37 in patients with diabetes mellitus complicated with pulmonary tuberculosis. Methods The hospital with diabetes and pulmonary tuberculosis patients were randomly selected, divided into 3 groups (n=40) respectively: diabetes mellitus group (experimental group 1), pulmonary tuberculosis group (experimental group 2), diabetes mellitus complicated with pulmonary tuberculosis group (experimental group 3);and healthy volunteers were randomly selected as control group (n=40).ELISA was used to analayze and compare Serum TNF-α, IFN-γ, expression of IL-6 and IL-37 between the 4 groups. Results The expression level of TNF-α, IFN-γ, IL-6 and IL-37 in the peripheral blood serum in the patients in the 1,2,3 group were significantly higher than the control group of volunteers (experimental group 1 respectively (0.39±0.11),(0.23±0.09),(11.20±4.32),(6.64±2.99) g/L;experimental group 2 respectively (0.65±0.13),(0.27±0.08),(17.80±4.10),(8.75±3.52) g/L;experimental group 3 respectively (0.99±0.14),(0.38±0.07),(25.80±5.29),(9.87±3.95) g/L;control group respectively (0.27±0.12),(0.20±0.05),(5.71±3.97),(4.32±2.18) g/L (t test values between experimental group 1 and the control were 20.785, 0.367, 27.659, 3.984, except for IFN-γ, P<0.05;t test values between experimental group 2 and the control were 65.818,1.039,13.682, 5.440,P<0.05;t test values between experimental group 3 and the control were 115.997,2.736,18.849,5.292,P<0.05);and the disease more severe the cytokine level was higher, the expression level of 4 cytokine in experimental group 3 were significantly higher than the experimental group 1,2 (t test values between experimental group 1 and experimental group 3 were respectively -51.961, -8.544, -14.977, -6.158, P<0.05;t test values between the experimental group 2 and the control group were respectively 65.818,1.039,13.682,5.440, P<0.05), while the 4 cytokine levels in experimental group 2 group were higher than that of experimental group 1 (t test values between experimental group 1 and experimental group 2 were respectively -22.517, -5.081, -28.844, -7.938, P<0.05);in the experimental group 3, the IL-37 level in patients with the lung cavity ((10.85±4.19) g/L) was significantly higher than that of no cavities ((4.98±2.38) g/L) (t=9.124, P<0.05). Conclusion There was a close correlation between the immune response and TNF-α, IFN-γ, IL-6 and IL-37 expression levels in diabetes complicated with pulmonary tuberculosis patients, the level of expression of the 4 cytokines associated with the severity of the disease.