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中华肺部疾病杂志(电子版)

中华肺部疾病杂志(电子版) ›› 2019, Vol. 12 ›› Issue (06) : 717 -721. doi: 10.3877/cma.j.issn.1674-6902.2019.06.010

论著

睾酮、雌二醇在男性肺结核合并炎症性贫血患者中的表达意义
黄东轩1, 廖毅力2, 何朝文1,†(), 黄冬生1, 彭剑锋1, 杨帆1, 曹亚辉1   
  1. 1. 518110　广东，深圳市龙华区中心医院呼吸与危重症医学科
    2. 518028　广东，深圳市妇幼保健院产科
  • 收稿日期:2019-07-13 出版日期:2019-12-20
  • 通信作者: 何朝文
  • 基金资助:
    深圳市科技计划(JCYJ20180306172419505)

Expression of testosterone and estradiol in male patients with pulmonary tuberculosis combined with anemia of inflammation

Dongxuan Huang1, Yili Liao2, Chaowen He1,†(), Dongsheng Huang1, Jianfeng Peng1, Fan Yang1, Yahui Cao1   

  1. 1. Department of Respiratory and Critical Care Medicine, Shenzhen Longhua District Central Hospital, ShenZhen 518110, China
    2. Department of Obstetrics, Shenzhen Maternity&Child Healthcare Hospital, Shenzhen 518028, China
  • Received:2019-07-13 Published:2019-12-20
  • Corresponding author: Chaowen He
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引用本文：

黄东轩, 廖毅力, 何朝文, 黄冬生, 彭剑锋, 杨帆, 曹亚辉. 睾酮、雌二醇在男性肺结核合并炎症性贫血患者中的表达意义[J]. 中华肺部疾病杂志(电子版), 2019, 12(06): 717-721.

Dongxuan Huang, Yili Liao, Chaowen He, Dongsheng Huang, Jianfeng Peng, Fan Yang, Yahui Cao. Expression of testosterone and estradiol in male patients with pulmonary tuberculosis combined with anemia of inflammation[J]. Chinese Journal of Lung Diseases(Electronic Edition), 2019, 12(06): 717-721.

目的

探讨睾酮(testosterone, T)、雌二醇(estradiol, E2)在肺结核(TB)合并炎症性贫血(AI)患者中的表达及其与疾病的相关性。

方法

选择2018年1月至2019年9月于我院确诊的TB患者39例和TB合并AI患者34例作为研究对象，获取患者基线资料，年龄、身高、身体质量指数(BMI)、吸烟史、饮酒史、高血压病史、糖尿病病史、实验室指标，红细胞计数(RBC)、血红蛋白(Hb)、网织红细胞计数(RET)、激素水平，睾酮(T)、雌二醇(E2)，构建体外刺激实验确定E2、T与免疫机制关系；采用Spearman相关系数分析T、E2与实验室指标相关性；利用独立因子所建立的Logistic回归模型对所有样本进行诊断测试，分析并发AI的影响因素。

结果

TB组和TB合并AI组患者身高、BMI、吸烟史、饮酒史、高血压病史、糖尿病病史比较无显著差异(P>0.05)，年龄、RBC、Hb、RET、E2、T比较有显著差异(P<0.05)。E2与T呈显著正相关关系(P<0.05)；E2、T与RBC、Hb、RET均呈显著正相关关系(P<0.05)。RBC、Hb、E2、T为保护因素(P<0.05)，年龄、RET是TB并发AI独立影响因素(P<0.05)。加入T、E2刺激的实验组CD3+、CD8+下降趋势较空白组有显著差异(P<0.05)。

结论

高表达T、E2可提高TB患者免疫机制和红细胞活化功能，对降低AI发生率有较高价值。

关键词: 睾酮, 雌二醇, 肺结核, 炎症性贫血, 表达意义
Objective

To investigate the expression levels of testosterone (T) and estradiol (E2) in the male patients with pulmonary tuberculosis (TB) complicated with anemia of inflammation (AI) and to analyze their correlation with the disease.

Methods

A total of 39 TB patients combined with no AI and 34 TB patients combined with AI confirmed in our hospital from January 2018 to September 2019 were enrolled in this study. The baseline data [age, height, body mass index (BMI), smoking history, drinking history, hypertension history, and diabetes history], laboratory indicators [red blood cell (RBC), hemoglobin (Hb), and reticulocyte count (RET)], and hormone levels (T and E2) were collected. The relationship between E2 and T and the immune mechanism was determined by in vitro stimulation. Spearman correlation coefficient was used to analyze the correlation between T and E2 and the laboratory indexes. Logistic regression model established by independent factors was used to analyze the influencing factors of AI.

Results

There was no significant difference in height, BMI, smoking history, drinking history, hypertension history or diabetes history between TB group and TB combined with AI group (P>0.05). There were significant differences in age, RBC, Hb, RET, E2 and T between the two groups (P<0.05). E2 was significantly positively correlated with T (P<0.05), E2 and T were significantly positively correlated with RBC, Hb and RET (P<0.05). RBC, Hb, E2, and T were the protective factors (P<0.05), and RET was the independent influencing factor of TB combined with AI (P<0.05). The decrease of CD3+ and CD8+ in the TB combined with AI group with T and E2 stimulation was significantly different from that in TB group (P<0.05).

Conclusion

High expression of T and E2 can improve the immune mechanism and the activation function of the red cells of TB patients, which is of great value in reducing the incidence of AI.

Key words: Testosterone, Estradiol, Tuberculosis, Anemia of inflammation, Expression
表1 TB两组临床资料[(±s)，n(%)]
临床资料 TB合并AI组(n＝34) TB组(n＝39) t/χ2值 P值
吸烟史(有/无) 22/12 20/19 1.340 0.247
饮酒史(有/无) 20/14 18/21 1.168 0.280
高血压病史(有/无) 16/18 20/19 0.130 0.719
糖尿病病史(有/无) 20/14 16/23 2.302 0.129
年龄(岁) 55.32±1.15 48.24±1.17 25.996 <0.001
身高(cm) 164.24±2.11 164.11±2.09 0.264 0.793
BMI(kg/m2) 24.02±1.13 23.98±1.20 0.146 0.884
RBC(×1012/L) 31.18±3.97 35.63±4.30 4.570 <0.001
Hb(g/L) 104.35±12.30 143.25±11.66 13.860 <0.001
RET(×109/L) 22.09±1.44 18.62±1.65 9.505 <0.001
T(pg/ml) 4.46±0.32 5.84±0.41 15.858 <0.001
E2(pmoL/L) 4.30±0.29 5.81±0.33 20.624 <0.001
图1 T、E2相关性图
表2 E2、T与RBC、Hb、RET相关性分析
项　目 E2(pmoL/L) T(pg/ml)
R P R P
RBC(×1012/L) 0.563 P<0.05 0.702 P<0.05
Hb(g/L) 0.647 P<0.05 0.617 P<0.05
RET(×109/L) 0.499 P<0.05 0.638 P<0.05
表3 TB并发AI危险因素分析
因素 β S.E Wald P OR 95%CI
Low up
年龄 0.490 0.173 8.047 0.005 1.633 1.164 2.292
E2 -0.550 0.164 11.233 0.001 0.577 0.418 0.796
T -0.631 0.184 11.789 0.001 0.532 0.371 0.763
RBC -0.121 0.046 7.001 0.008 0.886 0.810 0.969
Hb -0.168 0.053 9.995 0.002 0.845 0.761 0.938
RET 0.349 0.110 10.112 0.001 1.418 1.143 1.759
图2 T、E2对T细胞体外刺激诱导实验图；注：A：空白组CD3+水平变化；B：实验组CD3+水平变化；C：空白组CD8+水平变化；D：实验组CD8+水平变化
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