血清IL-15 AAG水平与肺结核化疗患者预后的相关性  

Correlation Between Serum IL-15,AAG Levels and Prognosis of Patients with Pulmonary Tuberculosis After Chemotherapy

作　　者：张天蔚 彭婷 李永武 王艳波 钟业腾 ZHANG Tianwei;PENG Ting;LI Yongwu(The Second Affiliated Hospital of Hainan Medical College,Hainan Haikou 570311,China)

机构地区：[1]海南医学院第二附属医院检验科,海南海口570311

出　　处：《河北医学》2022年第1期141-145,共5页Hebei Medicine

基　　金：海南省医药卫生科研项目,(编号:19A200162)。

摘　　要：目的:观察血清白细胞介素-15(IL-15)、α1-酸性糖蛋白(AAG)与肺结核化疗患者预后的相关性,指导临床合理评估肺结核化疗患者预后与干预。方法:选择本院2017年2月至2019年2月收治221例肺结核患者作为研究对象,采用我院自制调查表收集患者基线资料,全部患者均接受化疗,治疗2个月,检测细胞因子[干扰素-γ(IFN-γ)、肿瘤坏死因子-α(TNF-α)、巨噬细胞移动抑制因子(MIF)及IL-15]水平及AAG水平,记录患者治疗8个月后痰涂片镜检转阴状况,结合胸部X线检查评估患者预后,将患者分为预后不良组(n=69)和预后良好组(n=152)。比较两组基线资料、细胞因子水平及AAG水平,分析血清AAG水平及各指标与患者预后关系。结果:221例肺结核患者治疗8个月时,有152例预后良好,有69例预后不良;比较肺结核化疗预后良好组与预后不良组基线资料、细胞因子水平、AAG水平后,将差异有统计学意义的指标分别作为自变量,患者预后为因变量,建立多元回归模型,结果显示,肺结核化疗患者治疗2个月IFN-γ、TNF-α、MIF、IL-15过表达,AAG表达下调均是患者预后不良风险因子(OR>1,P<0.05);绘制受试者工作曲线(ROC)发现,肺结核患者治疗2个月IFN-γ、TNF-α、MIF、IL-15、AAG水平预测预后不良风险的曲线下面积(AUC)>0.71,均有一定预测价值,且以AAG预测AUC最高。结论:肺结核化疗患者不良预后风险较高,与治疗二个月IFN-γ、TNF-α、MIF、IL-15、AAG表达异常有关,其中IL-15及AAG表达水平对肺结核化疗患者预后的影响及预测价值较高,可根据治疗期间检测结果,指导预后风险预测与治疗方案调整。Objective:To observe the correlation between serum interleukin-15(IL-15),α1-acid glycoprotein(AAG)and prognosis of patients with pulmonary tuberculosis after chemotherapy,to guide the clinical rational evaluation of prognosis and intervention of patients with ulmonary tuberculosis after chemotherapy.Methods:A total of 221 patients with pulmonary tuberculosis admitted to our hospital from February 2017 to February 2019 were selected as the research subjects,and the baseline data of patients were collected by self-made questionnaire of our hospital.All patients received chemotherapy,and after 2 months of treatment,the levels of cytokines[interferon-γ(IFN-γ),tumor necrosis factor-α(TNF-α),macrophage migration inhibitory factor(MIF)and IL-15]and AAG were detected.The status of sputum smear having turned negative was recorded after 8 months of treatment.The prognosis of the patients was evaluated by chest X-ray examination.The patients were divided into poor prognosis group(n=69)and good prognosis group(n=152).The baseline data,cytokine levels and AAG levels of the two groups were compared,and the relationship between serum AGG level and each indicator and prognosis of patients was analyzed.Results:After 8 months of treatment,152 of 221 patients with pulmonary tuberculosis had a good prognosis and 69 had a poor prognosis.After comparing the baseline data,cytokine levels and AAG levels between the good prognosis group and the poor prognosis group,the indicators with statistically significant differences were taken as independent variables,and the prognosis of patients was a dependent variable.Multiple regression model was established,and the results showed that the over expression of IFN-γ,TNF-α,MIF,IL-15 and down-regulation of AAG were all risk factors of poor prognosis in patients with pulmonary tuberculosis treated with chemotherapy for 2 months(OR>1,P<0.05).The receiver operating curve(ROC)was plotted and revealed that IFN-γ,TNF-α,MIF,IL-15 and AAG levels predicted the area under the curve(AUC)of the risk

关 键 词：肺结核 白细胞介素-15 Α1-酸性糖蛋白 干扰素-γ 肿瘤坏死因子-α 移动抑制因子 化疗 

分 类 号：R521[医药卫生—内科学]