摘要：目的 探讨肺结核患者痰上清液及血清中骨桥蛋白（OPN）、白细胞介素-18（IL-18）和干扰素-γ（IFN-γ）水平的变化及其临床意义。 方法 选择初治的活动性肺结核患者96例，正常对照组84例，应用酶联免疫吸附法（ELISA）测定痰上清液及血清中OPN、IL-18和IFN-γ水平。 结果 肺结核患者组血清中OPN、IL-18和IFN-γ水平明显高于正常对照组，痰上清液中OPN、IL-18和IFN-γ水平明显高于正常对照组，差异均有统计学意义（P<0.05）。痰中含菌量越多，痰上清液中OPN、IL-18和IFN-γ水平越高，但差异无统计学意义（P>0.05）。 结论 肺结核患者痰上清液及血清中OPN、IL-18、IFN-γ水平明显升高。肺结核病变局部免疫反应更强烈，产生更多的炎症因子。

Abstract: Objective To investigate the levels of osteopontin (OPN), interleukin-18 (IL-18) and interferon-gamma (IFN-γ) in sputum supernatant and serum in patients with pulmonary tuberculosis and its clinical significance. Methods Totally 96 patients with untreated pulmonary tuberculosis in our hospital and 84 normal controls were selected. Enzyme-linked immunosorbent assay (ELISA) was used to assay the levels of OPN, IL-18 and IFN-γ in sputum supernatant and serum samples. Results The levels of OPN, IL-18 and IFN-γ in serum in patients with pulmonary tuberculosis were increased significantly than those in control group, and the levels of OPN, IL-18 and IFN-γ in sputum supernatant were obviously higher than those control group. The levels of OPN, IL-18 and IFN-γ in sputum supernatant were increased with increasing of the amount of bacteria in sputum, but without statistically significant (P>0.05). Conclusion The levels of OPN, IL-18 and IFN-γ in sputum supernatant and serum in patients with pulmonary tuberculosis are increased significantly. Immune responses in pulmonary lesions of patients with pulmonary tuberculosis are much more strongly than systemic inflammatory response, and produce more inflammatory cytokines.