AGP、AAT及HAP联合细胞因子检测在活动性肺结核中的诊疗价值  

The application value of AGP,AAT and HAP combined with cytokines detection in active pulmonary tuberculosis

作　　者：沈凌筠 王霖 马志强 张艳 王晓燕 SHEN Lingjun;WANG Lin;MA Zhiqiang;ZHANG Yan;WANG Xiaoyan(Yunnan Clinical Medical Center for Infectious Diseases/Third Department of Tuberculosis,The Third People′s Hospital of Kunming,Kunming,Yunnan 650301,China)

机构地区：[1]云南省传染性疾病临床医学中心/昆明市第三人民医院结核三科,云南昆明650301

出　　处：《国际检验医学杂志》2022年第6期705-709,共5页International Journal of Laboratory Medicine

基　　金：昆明市医药卫生科技计划基金项目(2021-03-02-003)。

摘　　要：目的探讨α1-酸性糖蛋白(AGP)、α1-抗胰蛋白酶(AAT)及触珠蛋白(HAP)联合细胞因子检测在活动性肺结核中的应用价值,为活动性肺结核的实验室诊断提供参考依据。方法选取2020年3月至2021年3月昆明市第三人民医院收治的96例结核病患者为研究组,另选同期体检健康者83例作为对照组,比较两组AGP、AAT、HAP及细胞因子水平,评价其在活动性肺结核中的诊断价值。结果与对照组比较,研究组患者血清中AGP、AAT、HAP、免疫球蛋白A(IgA)、白细胞介素-6(IL-6)、人γ干扰素(IFN-γ)的水平升高、肿瘤坏死因子-α(TNF-α)的水平降低,差异均有统计学意义(P<0.05);其余免疫球蛋白G(IgG)、免疫球蛋白M(IgM)、白细胞介素-1(IL-1)等11种因子的水平在两组间比较差异无统计学意义(P>0.05)。对两组差异有统计学意义的7种指标进行受试者工作特征曲线(ROC曲线)分析,结果显示,HAP、AGP、AAT、IgA、IL-6、IFN-γ、TNF-α诊断活动性肺结核的曲线下面积(AUC)分别为0.672、0.678、0.709、0.606、0.664、0.645、0.606,差异有统计学意义(P<0.05),AAT单独检测的诊断效能较高;IL-6+TNF-α联合检测的诊断效能最高。Spearman相关分析显示,HAP与AGP、AGP与AAT、HAP与AAT之间均呈正相关(P<0.05)。结论HAP、AGP、AAT及IL-6、IFN-γ、TNF-α联合检测诊断活动性肺结核效能较高,值得临床推广应用。Objective To investigate the application value ofα1-acid glycoprotein(AGP),α1-antiproteinase(AAT)and haptoglobin(HAP)combined with cytokines detection in active pulmonary tuberculosis,and provide reference for the laboratory diagnosis of active pulmonary tuberculosis.Methods A total of 96 tuberculosis patients in Third People′s Hospital of Kunming from March 2020 to March 2021 were selected as research group.And 83 healthy people in the same period were selected as the control group.Levels of AGP,AAT,HAP and cytokines between the two groups were compared,and their application value in active pulmonary tuberculosis was evaluated.Results Compared with the control group,the serum levels of AGP,AAT,HAP,IgA,interleukin(IL)-6 and interferonγ(IFN-γ)in patients with active tuberculosis increased,the level of TNF-αdecreased,the differences were statistically significant(P<0.05),the levels of other 11 factors such as IgG,IgM and IL-1 were not statistically different between the two groups(P>0.05).Receiver operating characteristic curve(ROC curve)analysis showed that the AUC values of the 7 indicators of HAP,AGP,AAT,IgA,IL-6,IFN-γand TNF-αrespectively were 0.672,0.678,0.709,0.606,0.664,0.645,0.606,the differences were statistically significant(P<0.05),single detection of AAT had higher diagnostic efficiency.In the two-indexes or three-indexes combined test,combined detection of IL-6+TNF-αhad the highest diagnostic efficiency.Spearman correlation analysis showed that HAP and AGP,AGP and AAT,HAP and AAT all had positive correlations(P<0.05).Conclusion Combined detection of HAP,AGP,AAT,IL-6,IFN-γand TNF-αhas higher efficiency in diagnosis of active tuberculosis.

关 键 词：活动性肺结核 Α1-酸性糖蛋白 Α1-抗胰蛋白酶 触珠蛋白 

分 类 号：R521.1[医药卫生—内科学]