Objective To explore the changes of IL-12,IL-18,IL-10 in the pleural fluid and serum of tuberculosis (TB)patients during the disease course.Methods 60 TB patients were selected as test subjects in this study,all patients with pleural fluid and serum were taken for testing.The pleural fluid and serum IL -12,IL -18 IL-10 changes,more naive patients and patients with pleural effusion retreatment and serum IL -12,IL -18,IL -10 content differences were observed and analyzed.Results Both in the initial treatment or retreatment group of pa-tients,the IL -12 and IL -10 levels in pleural effusion were significantly higher than those in the serum,the differ-ences were statistically significant(all P =0.000),and IL -18 content of pleural effusion in a little early treatment group was lower than that of the serum,the differences was not statistically significant(P =0.151),and the IL -12 and IL -10 contents in the pleural fluid and serum were higher than the retreatment of patients previously untreated patients.The IL -12 level in pleural effusion of Ⅱ type patients was (3 025.80 ±1 324.75)pg/mL,which in the ser-um was (498.84 ±326.73)pg/mL,which in the pleural effusion was significantly higher than in the serum(P =0.020),and the IL -12 levels in pleural effusion of Ⅲ -TB and Ⅳ type TB patients were also significantly higher than those in the serum,the differences were statistically significant(all P =0.000).The IL -18 level in pleural effu-sion of Ⅱ type patients was (1 735.54 ±872.65)pg/mL,which in pleural effusion of Ⅲ patients was (754.63 ± 426.87)pg/mL,in pleural effusion of Ⅳ patients was (655.19 ±412.63)pg/mL or so,and serum IL -18 levels in patients with different types of pleural TB had no obvious rule,the differences were not statistically significant(P =0.998 4).The IL -10 level in pleural effusion of Ⅱ type patients was (29.35 ±8.46)pg/mL,which in pleural effu-sion of Ⅲ patients was (183.49 ±56.76)pg/mL,which in pleural effusion of Ⅳ patients was (162.95 ±52.43)pg/mL,the IL -10 content of pleural in different clinical types of TB patients was different,which were significantly high-er than those in the serum,the differences were statistically significant(P =0.000).Conclusion TB patients in the disease,pleural effusion IL -12 and IL -10 are significantly higher than the serum,and retreatment of patients with pleural effusion IL -12,IL -10 levels are significantly higher than the untreated patients,but IL -18 in serum has no significant variation in pleural fluid.

Objective:To evaluate the effect and safety of rifabutin combined with multi-drugs in the treatment of multi-drug resist-ant tuberculosis with long-term therapy. Methods:Totally 86 cases of patients with multi-drug resistant tuberculosis were divided into the control group and the treatment group with 43 ones in each according to a random number table method. The two groups were trea-ted with levofloxacin, pasiniazid, ethambutol, protionamide and amikacin etc. The control group was treated with rifapentine, and the treatment group was treated with rifabutin additionally. After 18-month treatment, the negative conversion ratio of sputum smear and sputum mycobacterium tuberculosis culture, lesion absorption rate and cavity closure rate of X-ray chest radiograph and adverse reac-tions in the two groups were compared. Results:The negative conversion ratio of sputum smear and sputum mycobacterium tuberculosis culture in the treatment group was 41. 86% and 32. 56%, respectively, which were similar with those in the control group ( P >0. 05). There were no significant differences in lesion absorption rate and cavity closure rate of X-ray chest radiograph and adverse re-actions between the two groups (P>0. 05). Conclusion:Rifapentine or rifabutin combined with multi-drugs in the treatment of multi-drug resistant tuberculosis can improve the negative conversion rate of sputum mycobacterium and lesion absorption and cavity closure with high safety.