Abstract: Objective To analyze the expression of serum monocyte chemoattractant protein-1 (MCP-1), interferon-γ (INF-γ) and interleukin-18 (IL-18) in patients with pulmonary tuberculosis, and to explore their clinical value in the diagnosis and treatment of pulmonary tuberculosis. Method From January 2019 to June 2021, 85 patients with active pulmonary tuberculosis who were treated in Futian District Chronic Disease Prevention in Shenzhen were selected, and they were divided into mild group (51 cases) and severe group (34 cases). Serum INF-γ, IL-18 and MCP-1 levels of patients with different clinical characteristics were compared. And the serum INF-γ, IL-18 and MCP-1 levels before and after treatment between the mild and severe groups- were compared; The serum INF-γ, IL-18 and MCP-1 levels of patients with different absorption levels of lesions in the mild and severe groups. The correlation between serum INF-γ, IL-18, MCP-1 levels and acute physiology and chronic health evaluation (APACHE) Ⅱscore in patients with active pulmonary tuberculosis was analyzed. 85 patients of the active group received drug treatment. The serum INF-γ, IL-18 and MCP-1 levels in 2 months for treatment were compared with those before treatment, and the ratio values of their concentrations were obtained. The receiver operating characteristic curve (ROC curve) was drawn to analyze the efficiency of the ratio value of serum INF-γ, IL-18 and MCP-1 in evaluating the therapeutic effect of pulmonary tuberculosis. Result The levels of serum INF-γ, IL-18 and MCP-1 of patients with ≥ 2 lung fields, cavities, and severe pulmonary tuberculosis were higher than those of patients with one lung field, no cavities, and mild tuberculosis (P<0.001); The number of voids, sputum examination outcome and clinical symptom scores were significantly reduced in both mild and severe groups, with a statistically significant difference between before treatment in this group (P<0.001). The levels of Serum INF-γ,IL-18 and MCP-1 of patients after treatment in mild and severe groups were significantly reduced (P<0.001); The levels of serum INF-γ,IL-18 and MCP-1 of significantly absorb, absorb, and not absorb patient of mild and severe groups gradually increased (P<0.001);Pearson correlation analysis showed that the serum levels of INF-γ, IL-18 and MCP-1 of the active group were positively correlated with APACHEⅡ score (r=0.428, 0.505 and 0.581, P<0.001). The ROC curve showed that the area under the curve (AUC) of the ratio value of serum INF-γ, IL-18 and MCP-1 in evaluating the treatment effect of pulmonary tuberculosis was 0.808, and the sensitivity and specificity were 85.4% and 72.9%, respectively. Conclusion The serum levels of INF-γ, IL-18 and MCP-1 can reflect the severity of pulmonary tuberculosis and the effect of anti-tuberculosis treatment.

Key words: Tuberculosis, Monocyte chemoattractant protein-1, Interferon-γ, Interleukin-18, Disease condition, Efficacy