结核性胸膜炎患者胸腔积液及血清PD-1/PD-L1通路蛋白表达及其诊断价值  

Expression of PD-1/PD-L1 pathway protein in pleural effusion and serum of patients with tuberculous pleurisy and its diagnostic value

作　　者：姜建春[1] 姜新华[1] 周群英[2] 黄娟 樊最末 JIANG Jian-chun;JIANG Xin-hua;ZHOU Qun-ying;HUANG Juan;FAN Zui-mo(Zhejiang Quhua Hospital,Quzhou,Zhejiang 324004,China)

机构地区：[1]浙江衢化医院检验科,浙江衢州324004 [2]浙江衢化医院科教科,浙江衢州324004 [3]浙江衢化医院呼吸与危重症医学科,浙江衢州324004

出　　处：《中华医院感染学杂志》2021年第19期2954-2958,共5页Chinese Journal of Nosocomiology

基　　金：浙江省基础公益研究计划基金资助项目(LY20H200001)。

摘　　要：目的探讨结核性胸膜炎(TP)患者胸腔积液及血清中程序性死亡受体-1/程序性死亡受体配体-1(PD1/PD-L1)通路蛋白表达及其诊断价值。方法选择浙江衢化医院2017年3月-2020年3月收治的TP患者75例作为研究组,选择同期医院收治的非结核性胸膜炎患者60例作为对照组。两组患者均于入院当天(治疗前)、治疗2个月、治疗6个月时无菌抽取胸腔积液及外周血标本,采用酶联免疫吸附法(ELISA)检测两组胸腔积液及血清中可溶性PD-1、PD-L1蛋白表达水平。结果研究组TP患者入院时胸腔积液及血清中PD-1、PD-L1水平(143.35±31.77)ng/ml、(75.32±19.20)ng/ml及(49.94±18.60)ng/ml、(31.37±11.50)ng/ml均高于对照组(P<0.001);受试者工作特征(ROC)曲线分析结果表明,胸腔积液PD-1、胸腔积液PD-L1、血清PD-1、血清PD-L1水平用于结核性胸膜炎诊断,其曲线下面积分别为0.862、0.815、0.755、0.769(P<0.05);与治疗前相比,TP患者抗结核治疗2个月、治疗3个月时胸腔积液及血清中PD-1、PD-L1水平均低于治疗前(P<0.05);治疗2个月与治疗3个月时,两组胸腔积液及血清中PD-1、PD-L1水平差异无统计学意义;TP患者抗结核治疗3个月时,胸腔积液未完全吸收组胸腔积液及血清中PD-1、PD-L1水平高于完全吸收组(P<0.05)。结论胸腔积液及血清中PD-1、PD-L1水平对诊断及病情判断具有一定的价值。OBJECTIVE To investigate the expression of programmed death receptor-1/programmed death receptor ligand-1(PD1/PD-L1)pathway protein in pleural effusion and serum of patients with tuberculous pleurisy(TP)and its diagnostic value.METHODS Totally 75 TP patients admitted to Zhejiang Quhua Hospital from Mar.2017 to Mar.2020 were selected as the research group.and 60 non-tuberculous pleurisy patients admitted to the hospi-tal during the same period were selected as the control group.Pleural effusion and peripheral blood samples were collected aseptically on the day of admission(before treatment).2 months of treatment.and 6 months of treat-ment.Soluble PD-1 and PD-L1 protein expression levels in the pleural effusion and serum of the t wo groups were detected by enzyme-linked immunosorbent assay(ELISA).RESULTS The levels of PD-1 and PD-L1 in pleural ef-fusion and serum of TP patients in the study group were(143.35±31.77)ng/ml,(75.32±19.20)ng/ml,(49.94±18.60)ng/ml,and(31.37±11.50)ng/ml.respectively.significantly higher than the control group(P<0.001);The results of receiver operating characteristic curve(ROC)analysis showed that the area under the curve of pleu-ral effusion PD-1.pleural effusion PD-L1.serum PD-1.serum PD-L1 level for the diagnosis of tuberculosis pleurisy was 0.862,0.815.0.755.and 0.769,respectively(P<0.05);compared with before treatment,the levels of PD-1 and PD-L1 in effusion and serum of TP patients after anti-tuberculosis treatment for 2 months and 3 months were significantly lower than those before treatment(P<0.05);There was no significant difference in the levels of PD-1 and PD-L1 in pleural effusion and serum between the two groups at 2 months and 3 months of treatment;after 3 months of anti-tuberculosis treatment in TP patients,the levelsof PD-1 and PD-L1 in the pleural effusion and serum of the incomplete pleural effusion group were significantly higher than those of the completely absorbed group(P<0.05).CONCLUSION The levelsof PD-1 and PD-L1 in pleural effusion and serum have certain value

关 键 词：结核性胸膜炎 胸腔积液 程序性死亡受体-1 程序性死亡受体配体-1 诊断价值 

分 类 号：R521.7[医药卫生—内科学]