血清腺苷脱氨酶联合全血微小RNA-197-3p在人布鲁氏菌病诊断中的临床价值  

Clinical value of serum adenosine deaminase combined with whole blood microRNA-197-3p in the diagnosis of human brucellosis

作　　者：吕高超[1] 武薇[1] 汤凤莲 刘福岩 Lyu Gaochao;Wu Wei;Tang Fenglian;Liu Fuyan(Department of Pulmonary and Critical Care Medicine,Affiliated Hospital of Jining Medical University,Jining 272000,China;Department of Laboratory,Affiliated Hospital of Jining Medical University,Jining 272000,China)

机构地区：[1]济宁医学院附属医院呼吸与危重症医学科,济宁272000 [2]济宁医学院附属医院检验科,济宁272000

出　　处：《中华地方病学杂志》2024年第7期593-597,共5页Chinese Journal of Endemiology

基　　金：济宁市重点研发计划项目(2022YXNS037);济宁医学院附属医院主诊医师团队临床研究专项计划(ZZTD-MS-2023-20)

摘　　要：目的探讨血清腺苷脱氨酶(adenosine deaminase,ADA)联合全血微小RNA(microRNA,miR)-197-3p在人布鲁氏菌病(简称布病)诊断中的临床价值。方法2020年1月至2023年9月,在济宁医学院附属医院(简称本院)呼吸与危重症医学科选取布病患者120例,设为布病组,其中急性期组89例、慢性期组19例、隐匿感染组12例。另于同期在本院体检人群中选取畜牧业从业健康志愿者60例,设为对照组;在本院呼吸与危重症医学科选取社区获得性肺炎重症患者60例,设为感染对照组。布病组和感染对照组患者均予以规范治疗。布病、感染对照组患者分别于治疗前后、对照组受试者于入组时采集清晨空腹肘静脉血,检测血清ADA及全血miR-197-3p水平。采用多因素logistic回归分析探讨影响布病发生的危险因素,采用受试者工作特征(receiver operating characteristic,ROC)曲线评估ADA、miR-197-3p及二者联合对布病的诊断效能。结果治疗前,对照、感染对照、急性期、慢性期、隐匿感染组血清ADA(U/L:12.35±2.89、18.33±4.57、29.75±6.46、22.20±4.78、14.15±3.03)及全血miR-197-3p水平(1.09±0.33、2.25±0.41、2.68±0.59、2.43±0.51、1.18±0.40)比较,差异均有统计学意义(F=4.38、4.02,P=0.014、0.019)。与对照组比较,其余4组血清ADA和全血miR-197-3p水平均较高(均P<0.05)。与感染对照组比较,急性期、慢性期组血清ADA水平均较高,隐匿感染组血清ADA水平较低(均P<0.05);急性期组全血miR-197-3p水平较高,隐匿感染组全血miR-197-3p水平较低(均P<0.05)。与治疗前比较,治疗后感染对照、急性期、慢性期组血清ADA及全血miR-197-3p水平均较低(均P<0.05)。多因素logistic回归分析显示,血清ADA和全血miR-197-3p水平升高是布病发生的危险因素[比值比(odds ratio,OR)=2.235、3.404,95%置信区间(confidence intervals,CI):1.491~3.362、1.623~7.605,均P<0.001]。ROC曲线结果显示,血清ADA和全血miR-197-3p对布病诊断均具�Objective To study the clinical value of serum adenosine deaminase(ADA)combined with whole blood microRNA(miR)-197-3p in the diagnosis of human brucellosis.Methods From January 2020 to September 2023,120 patients with brucellosis were selected from the Department of Pulmonary and Critical Care Medicine,Affiliated Hospital of Jining Medical University(referred to as this hospital)and assigned to the brucellosis group,including 89 patients in the acute stage,19 patients in the chronic stage,and 12 patients in the latent infection.In addition,60 healthy volunteers from the animal husbandry industry were selected as the control group from the physical examination population in this hospital during the same period;sixty critically ill patients with community-acquired pneumonia were selected from the Department of Pulmonary and Critical Care Medicine of this hospital as the infection control group.Patients in the brucellosis group and infection control group were given standardized treatment.Fasting elbow venous blood samples were collected in the morning before and after treatment in the brucellosis group and infection control group,at enrollment in the control group,and serum ADA and whole blood miR-197-3p levels were tested.Multivariate logistic regression analysis was used to study the risk factors affecting the occurrence of brucellosis.Receiver operating characteristic(ROC)curve was used to evaluate the diagnostic efficacy of ADA,miR-197-3p,and their combination for brucellosis.Results Before treatment,the levels of serum ADA(U/L:12.35±2.89,18.33±4.57,29.75±6.46,22.20±4.78,14.15±3.03)and whole blood miR-197-3p(1.09±0.33,2.25±0.41,2.68±0.59,2.43±0.51,1.18±0.40)in the control,infection control,acute stage,chronic stage,and latent infection groups were compared,and the differences were statistically significant(F=4.38,4.02,P=0.014,0.019).Compared with the control group,the serum ADA and whole blood miR-197-3p levels in the other 4 groups were higher(P<0.05).Compared with the infection control group,the ser

关 键 词：布鲁氏菌病 腺苷脱氨酶 微小RNA-197-3p 

分 类 号：R516.7[医药卫生—内科学]