关键词: 结核, 支气管疾病, 支气管肺泡灌洗液, 黏蛋白质类, 雌二醇

Abstract:

Objective: To explore the correlation between the expression of estradiol and Mucoprotein 5B in airway Goblet cell and the inflammatory level and clinical prognosis of patients with bronchial tuberculosis. Methods: A prospective cohort study was conducted in the patients who admitted to Shaanxi Provincial Hospital of Tuberculosis Prevention and Treatment from June 2020 to June 2022, and all of them underwent bronchoscopy. According to the inclusion criteria, they were included in the bronchial tuberculosis group (n=112) and the ordinary pulmonary tuberculosis group (n=62). The bronchial tuberculosis group was further divided into ulcer necrosis group (n=54) and scar stenosis group (n=58). A total of 60 healthy volunteers who underwent physical examination during the same period were selected as the normal lung lobe group. The levels of Mucoprotein 5B and serum estradiol in bronchoalveolar lavage fluid (BALF) were measured before and after one month of anti-tuberculosis treatment in the bronchial tuberculosis group and the ordinary pulmonary tuberculosis group, respectively; only serum estradiol levels were detected in the normal lung lobe group. The differences of Mucoprotein 5B level between the bronchial tuberculosis group and the ordinary pulmonary tuberculosis group before and after anti-tuberculosis treatment were compared, and the difference of estradiol level between the two groups before and after anti-tuberculosis treatment and the normal pulmonary lobe group were also compared, to analyze the correlation between Mucoprotein 5B and estradiol level in patients with bronchial tuberculosis ulcer necrosis group. Results: Before treatment, the level of Mucoprotein 5B in the ulcerative necrosis group was (33.39±7.20) μg/L, which was significantly higher than that in the scar stenosis group ((17.94±10.61) μg/L, t=11.137, P<0.01) and the ordinary pulmonary tuberculosis group ((14.47±5.15) μg/L, t=16.205, P<0.01). The level of Mucoprotein 5B in female patients of ulcerative necrosis group was (32.88±6.97) μg/L. After one month of anti-tuberculosis treatment, the level of Mucoprotein 5B in the ulcerative necrosis group was significantly lower than that before treatment ((22.86±6.71) μg/L, t=7.891, P<0.01), and also significantly higher than that in the scar stenosis group ((16.05±5.63) μg/L) and the ordinary pulmonary tuberculosis group ((12.67±3.69) μg/L), with a statistically significant difference (t values were 5.727 and 9.839, respectively, both P<0.01). The level of Mucoprotein 5B in female patients of ulcerative necrosis group was (22.37±6.57) μg/L. Before treatment, the estradiol levels in female patients with ulcerative necrosis were (120.54±30.66) pmol/L, significantly lower than those in female patients with scar stenosis ((145.31±45.06) pmol/L) or ordinary pulmonary tuberculosis ((154.58±51.35) pmol/L), or female volunteers in the normal lung lobe group ((230.46±76.85) pmol/L). The differences were statistically significant (t values were -1.788, -2.854, and -8.134, P values were 0.042, 0.016, and <0.01, respectively). After one month of anti-tuberculosis treatment, the estradiol level of female patients in the ulcer necrosis group ((154.90±47.07) pmol/L) significantly increased compared to that before treatment (t=-3.353, P=0.032); however, it was significantly lower than that of female patients in the general tuberculosis group ((195.19±57.23) pmol/L) and female volunteers in the normal lung lobe group ((230.46±76.85) pmol/L), with statistically significant differences (t values were -20.588 and -4.589; P values were 0.011 and <0.01, respectively). Linear correlation analysis showed that there was a strong negative correlation between Mucoprotein 5B in BALF and serum estradiol level in female patients with ulcerative necrosis before treatment (r=-0.669, P=0.001); one month after anti-tuberculosis treatment, the level of Mucoprotein 5B in BALF and serum estradiol in female patients with ulcerative necrosis showed a medium negative correlation (r=-0.498, P=0.005). Conclusion: Mucoprotein 5B and estradiol play a regulatory role in the occurrence and development of bronchial tuberculosis inflammation, and they may be related to the prognosis of bronchial tuberculosis.

Key words: Tuberculosis, Bronchial diseases, Bronchoalveolar lavage fluid, Mucoproteins, Estradiol