高原地区结核病患者糖类抗原125、超敏C反应蛋白水平及其临床意义  

Carbohydrate antigen 125 and high-sensitivity C-reactive protein levels and their clinical significance in tuberculosis patients on plateau

作　　者：肖静[1] 冯东方[1] 黄淮霖[1] 丁巳娟[1] 张宏伟 殷作明[1] 杨光[2] 韩起 XIAO Jing;FENG Dong-fang;HUANG Huai-lin;DING Si-juan;ZHANG Hong-wei;YIN Zuo-ming;YANG Guang;HAN Qi(The General Hospital of Tibet Military Area Command,Lhasa 850000,China;Institute of Fundamental Research,Academy of Military Medical Sciences,Beijing 100091,China)

机构地区：[1]西藏军区总医院,拉萨市850000 [2]军事医学科学院基础研究所,北京市100091

出　　处：《广西医学》2020年第21期2764-2767,共4页Guangxi Medical Journal

基　　金：西藏自治区自然科学基金(XZ2019ZRG-135)。

摘　　要：目的探讨高原地区结核病患者糖类抗原125(CA125)和超敏C反应蛋白(hs-CRP)的水平及其临床意义。方法将141例高原地区结核病患者作为结核组,同期体检的120例健康者作为对照组。比较两组血清CA125和hs-CRP水平,以及不同类型结核病患者的CA125和hs-CRP水平,观察2HRZE/4HR方案治疗3个月后结核病患者血清CA125和hs-CRP的变化,并分析CA125和hs-CRP联合检测诊断结核病的效能。结果治疗前结核组患者血清CA125和hs-CRP水平均高于对照组(均P<0.05),而不同类型的结核病患者血清CA125和hs-CRP的水平差异均无统计学意义(均P>0.05)。治疗3个月后,患者CA125和hs-CRP水平均较治疗前下降(均P<0.05)。CA125和hs-CRP联合检测诊断结核病的灵敏度为94.3%,高于二者单独检测的灵敏度(79.4%和85.1%),而联合检测的特异度为68.3%,低于二者单独检测的特异度(78.3%和83.3%)(均P<0.05)。结论高原地区结核病患者血清CA125和hs-CRP水平升高,两者均可以作为评估结核病患者病情及预后的指标,而两者联合检测可以提高结核病的检出率,降低漏诊率。Objective To explore the levels of carbohydrate antigen 125(CA125)and high-sensitivity C-reactive protein(hs-CRP)as well as their clinical significance in tuberculosis patients on the plateau.Methods A total of 141 tuberculosis patients on the plateau were enrolled as tuberculosis group,concurrently,120 check-up healthy individuals as control group.Serum CA125 and hs-CRP levels were compared between the two groups,and also compared among patients with different types of tuberculosis.Changes in serum CA125 and hs-CRP of tuberculosis patients were observed after three months of 2HRZE/4HRregimen treatment,and the diagnostic efficiency of combined detection of CA125 and hs-CRP for tuberculosis was analyzed.Results Before treatment,patients in the tuberculosis group had higher serum CA125 and hs-CRP levels than the control group(all P<0.05),but there was no statistically significant difference in serum CA125 or hs-CRP level among patients with different types of tuberculosis(all P>0.05).After three months of treatment,the levels of CA125 and hs-CRP were decreased in the patients than the levels before treatment(all P<0.05).The combined detection of CA125 and hs-CRP exhibited a sensitivity of 94.3%for diagnosing tuberculosis,which was higher than either of the two detections with respect to sensitivity(79.4%and 85.1%,respectively);however,the combined detection presented a specificity of 68.3%,which was lower than either of the two detections with respect to specificity(78.3%and 83.3%,respectively)(all P<0.05).Conclusion Tuberculosis patients on the plateau experience elevated serum CA125 and hs-CRP levels,these two indicators can act as the indicators for assessing severity and prognosis of tuberculosis patients,and their combined detection can improve the detection rate of tuberculosis and reduce missed diagnosis rate.

关 键 词：结核病 糖类抗原125 超敏C反应蛋白 高原地区 病情 预后 诊断 

分 类 号：R52[医药卫生—内科学]