目的 探讨结核病相关重症患者的诊治特点,提高此类疾病的诊治水平。方法 回顾性分析2020年7月—8月我科收住的4例临床表现类似的结核病相关重症患者的临床资料。结果 4例患者均诊断为活动性结核病或结核潜伏感染,均为合并1个或多个器官功能衰竭的重症患者,均表现为发热、血小板减少、肝肾损伤,经予以个体化的积极抢救治疗,均获得满意疗效。结论 结核病相关重症患者往往病情复杂危重,可能临床特点相似,但实际病因不同,因而治疗重点各异,需临床医生认真剖析病情,找到关键病因,以尽量挽救患者生命。

Objective To explore the characteristics of diagnosis and treatment of severe tuberculosis-related patients and improve diagnosis and treatment of such diseases. Methods Retrospectively analyzed the clinical data of 4 severe tuberculosis-related patients with similar clinical symptoms admitted to our department from July to August, 2020. Results All 4 patients were diagnosed as active tuberculosis or latent tuberculosis infection, with one or several organs failure, fever, thrombocytopenia, liver and renal injury. They were given individualized positive rescue treatment, and achieved satisfying outcomes. Conclusions Severe tuberculosis-related patients often have complex and critical conditions, and may have similar clinical characteristics, but the actual causes are different, so the treatment focuses are different. Clinicians need to carefully analyze the condition, find out the key causes, and try to save the lives of patients.

近年来的研究已经报道证实了白细胞介素-33(IL-33)及其受体ST2可以保护心衰病人因机械应力过度牵拉所导致的心肌细胞肥大、心肌纤维化的发生以及可溶性ST2受体可作为潜在的心脏机械超负荷生物标志物。而对IL-33与受体ST2在动脉粥样硬化过程中发挥的作用少有涉及。本文主要探讨的是IL-33和ST2对抑制Th1/Th2漂移从而影响到动脉粥样硬化的进展以及血浆中可溶性ST2受体蛋白升高的意义。

Recent study has reported that interleukin-33(IL-33) and its receptor ST2 could prevent cardiomyocyte hypertrophy and exaggerated interstitial fibrosis which is because of the over harmful biomechanical force in patients with heart failure and soluble ST2 receptors is the potential biomarker of cardiac biomechanical overload. But few studies mentioned the sort of IL-33/ST2 complex plays a role in atherosclerosis. The purpose of this article is to explore the IL-33 and ST2 could reduce a Th1/Th2 shift. Consequently, it may improve the development of atherosclerosis and significance of soluble ST2 receptor increased in plasma.