血清磷脂酶A2组ⅡA和凝血因子Ⅸ筛查耐多药肺结核病气阴两虚证的应用研究  

Application of Serum Phospholipase A2 Group ⅡA in Screening the Deficiency of Qi and Yin(DQY) Syndrome of Multidrug-resistant Tuberculosis

作　　者：胡玉婷 温成平[2] 江婷婷 范永升[2] 李继承 HU Yuting;WEN Chengping;JIANG Tingting(South China University of Technology School of Medicine. Guangzhou (510006), China;Zhejiang Chinese Medical University)

机构地区：[1]华南理工大学医学院,广州510006 [2]浙江中医药大学 [3]浙江大学

出　　处：《浙江中医药大学学报》2019年第5期440-446,共7页Journal of Zhejiang Chinese Medical University

基　　金：国家自然科学基金资助项目(81573709;81772266);国家重点基础研究发展计划(973计划)项目(2014CB543002)~~

摘　　要：[目的]探讨血清磷脂酶A2组ⅡA (phospholipase A2 groupⅡA,PLA2G2A)和凝血因子Ⅸ(coagulation factorⅨ,F9)对耐多药肺结核病(multidrug-resistant tuberculosis,MDR-TB)气阴两虚(deficiency of Qi and Yin,DQY)证的潜在诊断价值。[方法]选择MDR-TB肺阴虚(pulmonary Yin deficiency,PYD)证、MDR-TB阴虚火旺(hyperactivity of fire due to Yin deficiency,HFYD)证、MDR-TB DQY证患者和健康对照(healthy control,HC)者各15例,以ELISA检测每组PLA2G2A和F9的蛋白浓度,并利用受试者工作特征(receiver operating characteristic, ROC)曲线分析PLA2G2A和F9作为MDR-TB DQY证潜在生物学标志物的临床价值。[结果]MDR-TB证候分布以DQY证患者数最多,其次是HFYD证,再者是DQY证,而阴阳两虚(deficiency of Yin and Yang, DYY)证患者数最少。DQY证组PLA2G2A的蛋白浓度均明显高于PYD证组、HFYD证组和HC组,差异有统计学意义(P<0.05);DQY证组F9的蛋白浓度明显低于HFYD证组,差异有统计学意义(P<0.05)。ROC曲线结果显示,血清PLA2G2A有鉴别诊断MDR-TB DQY证的作用。[结论]血清PLA2G2A和F9在诊断MDR-TB DQY证方面具备一定临床价值,血清PLA2G2A可作为MDR-TB DQY证的潜在生物学标志物。[Objective] To investigate the potential diagnostic value of serum phospholipase A2 group ⅡA(PLA2 G2 A) and coagulation factor Ⅸ(F9) for deficiency of Qi and Yin(DQY) syndrome of multidrug-resistant tuberculosis(MDR-TB).[Methods]Patients with pulmonary Yin deficiency(PYD) syndrome of MDR-TB, hyperactivity of fire due to Yin deficiency(HFYD) syndrome of MDR-TB, DQY syndrome of MDR-TB, and healthy control(HC) were selected, and there were 15 cases in each group. The expression levels of PLA2 G2 A and F9 in the serum of each group were detected by enzyme-linked immunosorbent assay(ELISA), and the ROC curves were used to analyze the clinical value of PLA2 G2 A and F9 as potential biomarkers of MDR-TB DQY syndrome.[Results] The DQY syndrome distribution was the most common syndrome in MDR-TB patients, followed by HFYD syndrome, and DQY syndrome;and deficiency of Yin and Yang(DYY) syndrome patients were the least. The expression level of serum PLA2 G2 A in DQY syndrome group was significantly higher than that in PYD syndrome group, HFYD syndrome group and HC group, and the difference was statistically significant( P <0.05).While the expression level of serum F9 in DQY syndrome group was significantly lower than that in HFYD syndrome group( P<0.05). The results of ROC curve showed that serum PLA2 G2 A has differential diagnosis effect on MDR-TB DQY syndrome.[Conclusion] Serum PLA2 G2 A and F9 have certain clinical value in the diagnosis of MDR-TB DQY syndrome. Moreover, serum PLA2 G2 A is a potential biomarker for MDR-TB DQY syndrome.

关 键 词：耐多药肺结核病 中医学 证候 磷脂酶 凝血因子Ⅸ 潜在生物学标志物 酶联免疫吸附试验 

分 类 号：R331[医药卫生—人体生理学]