IL-8 mRNA定量检测在活动性结核病鉴别诊断中的价值  

Diagnostic value of IL-8 mRNA in the differential diagnosis of active tuberculosis

作　　者：曹志红[1] 曹彦[1] 程小星[1] 

机构地区：[1]解放军第309医院全军结核病研究所全军结核病防治重点实验室结核病诊疗新技术北京市重点试验室,北京100091

出　　处：《临床肺科杂志》2015年第9期1553-1555,1559,共4页Journal of Clinical Pulmonary Medicine

基　　金：国家自然科学基金资助(No 81071318)

摘　　要：目的研究活动性肺结核患者外周血单个核细胞(PBMCs)经结核特异性抗原刺激后白介素-8(interleukin-8,IL-8)的mRNA表达情况并与结核潜伏感染(latent tuberculosis infection,LTBI)及非结核感染健康对照组进行比较。方法提取研究对象的PBMCs,经特异性抗原肽刺激后,收集细胞并提取总RNA然后经实时荧光定量PCR检测技术比较各组IL-8 mRNA表达情况。然后以敏感性(sensitivity)为纵坐标,1-特异性(1-specificity)为横坐标绘制结核组和LTBI组相比较的ROC曲线。结果经结核特异性抗原刺激后,结核组PBMCs中IL-8基因mRNA的相对表达量明显高于LTBI和健康对照组,差异有统计学意义(P<0.05)。ROC曲线下面积为0.72。以3.985为临界值,鉴别活动性结核病和LTBI的敏感性和特异性分别为54.17%和90.00%,此时阳性似然比等于5.42,64.7%的病例诊断准确。结论 IL-8有可能作为新的活动性结核病诊断标志物,有助于活动性结核病与LTBI的鉴别诊断。Objective To compare the mRNA expression of IL-8 from PBMCs stimulated with Mtb-specific antigens between pulmonary tuberculosis patients with latent tuberculosis infection （LTBI） and non-tuberculosis in-fection healthy controls. Methods The mRNA expression of IL-8 from PBMCs stimulated with Mtb-specific antigens was quantitatively detected by quantitative real-time PCR （qPCR）. Receiver-operating-characteristic （ROC） curve was used to determine the cutoff points yielding the highest specificity and sensitivity, and discriminative ability was evaluated by the area under the ROC curve. Results The mRNA expression of IL-8 in tuberculosis patients was sig-nificantly higher than that in LTBI patients and healthy controls （P〈0. 05）. The AUC for using IL-8 mRNA level （〉3. 985） to identify active infection was 0. 72, with 54. 17% of sensitivity and 90% of specificity. The positive re-sult likelihood ratio was 5. 42, and 64. 7% of the cases were correctly classified. Conclusion The expression of IL-8 can be used as a biomarker for distinguishing between latent tuberculosis infection and active infection.

关 键 词：结核 趋化因子 IL-8 LTBI 

分 类 号：R52[医药卫生—内科学]