目的 探讨肺结核患者治疗前后血清细胞因子水平变化的临床意义。方法 采用酶联免疫吸附分析（ELISA）测定215例肺结核患者治疗前后和60例正常对照组血清细胞因子IL-2，IL-10，IL-17，IL-18水平，并进行对比性分析，测定了215例肺结核患者治疗后的痰菌转阴率和有效率，通过测定灵敏度、特异度和准确度等指标比较了单项和多项细胞因子在肺结核患者诊断中的变化。结果 215例肺结核患者治疗前血清IL-2和IL-10水平较之60例正常对照组明显降低（tIL-2=3.216,tIL-10=3.164,P均<0.01），而IL-17和IL-18水平明显增高（tIL-17=2.942,P<0.01,tIL-18=2.175,P均<0.05），治疗后血清IL-2和IL-10水平明显增高（tIL-2=2.237,tIL-10=2.248,P均<0.05）,而血清IL-17的水平降低（tIL-17=2.120,P<0.05）,血清IL-18恢复至正常水平（tIL-18=1.873,P>0.05）。215例肺结核治疗后的痰菌转阴率为87.00%，有效率为92.1%。结论 细胞因子参与肺结核的病理生理过程，并是治疗后随访的有价值指标。单项细胞因子测定在肺结核诊断中的价值较低，四项联合测定的灵敏度，特异度和准确度分别为69.8%，65.0%和72.0%。

Objective To explore the clinical significance of interleukin pathological physiologic process and treatment following in patients with pulmonary tuberculosis. Methods The serum levels of IL-2, IL-10, IL-17 and IL-18 in 215 patients with pulmonary tuberculosis before and after therapy and 60 controls were determined by ELISA. The sputum bacteria trans-negative rate and effective rate were analyzed in patients after therapy. The diagnostic effective comparison of single and multi interleukin was carried out by determining sensitivity, specificity and accuracy. Results Before therapy, the serum IL-2 and IL-10 levels in patients with pulmonary tuberculosis were significantly lower than those in 60 controls (P<0.01), but the serum IL-17 and IL-18 levels were significantly higher (P <0.05). After therapy the serum IL-2 and IL-10 in patients with pulmonary tuberculosis were significantly increased (P <0.05), the serum IL-17 levels was decreased (P <0.05) and the serum IL-18 levels was return normal (P >0.05). The sputum bacteria trans-negative rate and effective rate in patients with pulmonary tuberculosis after therapy was 87.00% and 92.1% respectively. The diagnostic value of single interleukin was low. The sensitivity, specificity and accuracy of combination determination of four interleukin were 69.8%, 65.0% and 72.0% respectively. Conclusion The interleukin may take part in pathological physiologic process and is valuable index before and after therapy in patients with pulmonary tuberculosis.