Quality of life and changes in cytokine factors among initial smear-positive pulmonary tuberculosis patients

Objective To evaluate changes in cytokine factors and quality of life(QOL)in patients with initial smear-positive pulmonary tuberculosis and to explore its main influencing factors,and to provide references for comprehensive prevention and treatment of tuberculosis.Methods Via cluster sampling,196 initial smear-positive pulmonary tuberculosis patients were recruited from Taizhou First People's Hospital and Wenling Tubertulosis Prevention Institution from June 2012 through May 2014.The levels of interferon gamma(INF-γ),interleukin-2(IL-2),interleukin-10(IL-10)and interleukin-18(IL-18)were determined at the day before and 2 months after the medication.The 36-Item Short Form Health Survey(SF-36)was used to evaluate QOL among the patients.The influencing factors for QOL were evaluated by using univariate and multivariate non-conditional logistic regression analysis.Results The levels of INF-γ and IL-2 two-month after the medication were 97.3±40.5 and 54.1±19.3 ng/L,higher than 43.2±17.3 and 36.3±13.9 ng/L before the medication(both P<0.05).The levels of IL-10 and IL-18 two-month after the medication were 82.3±29.4 and 130.9±50.3 ng/L,lower than 116.2±44.7 and 243.0±86.8 ng/L before the medication(both P<0.05).Two months after the medication,the levels of INF-γ and IL-2 in the patients with sputum smear-negative conversion were 109.8±35.4 and 58.1±18.7 ng/L,higher than 50.4±16.3 and 39.0±13.3 ng/L in the patients without the conversion(both P<0.05)and the levels of IL-10 and IL-18 in patients without sputum smear-negative conversion were 77.3±24.2 and 107.6±33.6 ng/L,lower than 102.4±32.9 and 221.3±69.2 ng/L in the patients with the conversion(both P<0.05).The QOL domain scores were 70.14±23.07 for physiological function,45.32±21.69 for role-physical,67.42±18.26 for bodily pain,61.28±26.34 for general health,49.32±16.85 for vitality,57.64±12.46 for social function,64.71±11.31 for role-emotional,and 52.83±20.47 for mental health and the overall QOL was 512.25±132.57;all the scores were lower than those of the norms of general population,with significant differences(all P<0.001).Logistic regression analyses showed that the patients aged more than 50 years,with debt,suffering from chronic disease,and being a farmer were more likely to have lower QOL score(all P<0.05);while the patients with education of junior middle school or above,with annual income of≥20 000 RMB yuan,with medical insurance,sputum smear-negative conversion two months after the medication,and with alleviated pulmonary lesions three months after treatment were more likely to have higher QOL score(all P<0.05).Conclusion Levels of cytokine factors increase after anti-tuberculosis medication among initial smear-positive pulmonary tuberculosis patients;the QOL of the patients was at a low level and mainly influenced by age,education level,occupation,average annual income per capita,whether with debt,chronic disease,medical insurance,and status of sputum smear conversion and alleviation of pulmonary lesion after treatment.