高分辨率CT评分联合血清sTREM-1、HBD-2对老年肺结核患者的预后价值  

Prognostic value of high-resolution CT score combined with serum sTREM-1 and HBD-2 in elderly patients with pulmonary tuberculosis

作　　者：王雪怡[1] 武文凤 丁巍[2] 周婷婷[1] WANG Xueyi;WU Wenfeng;DING Wei;ZHOU Tingting(Department of Public Health,Ministry of Healt,People′s Hospital of Xinjiang Uygur Autonomous Region,Urumqi,Xinjiang 830002,Chinah;Department of Respiratory,People′s Hospital of Xinjiang Uygur Autonomous Region,Urumqi,Xinjiang 830002,China)

机构地区：[1]新疆维吾尔自治区人民医院医务部公共卫生科,新疆乌鲁木齐830002 [2]新疆维吾尔自治区人民医院呼吸科,新疆乌鲁木齐830002

出　　处：《国际检验医学杂志》2023年第20期2479-2483,共5页International Journal of Laboratory Medicine

基　　金：新疆维吾尔自治区人民医院院内项目(20220249)。

摘　　要：目的探讨高分辨率CT(HRCT)评分与血清可溶性髓系细胞触发受体-1(sTREM-1)、β-防御素2(HBD-2)联合检测对老年肺结核患者预后的预测价值。方法纳入该院2021年5月至2023年5月收治的132例老年肺结核患者作为研究组,根据预后分为预后良好组96例和预后不良组36例。选取同期行HRCT检查的130例体检健康者作为对照组。采用酶联免疫吸附试验检测血清sTREM-1、HBD-2水平,采用受试者工作特征(ROC)曲线分析HRCT评分及血清sTREM-1、HBD-2水平对老年肺结核患者预后不良的预测价值,采用多因素Logistic回归分析老年肺结核患者预后不良的影响因素。结果研究组HRCT评分及血清sTREM-1、HBD-2水平均高于对照组(P<0.05)。治疗前及治疗后2、6个月,预后良好组HRCT评分及血清sTREM-1、HBD-2水平呈下降趋势(P<0.05),即存在时间效应。治疗后2、6个月,预后不良组HRCT评分及血清sTREM-1、HBD-2水平高于预后良好组(P<0.05),时间和分组因素存在交互效应。HRCT评分及血清sTREM-1、HBD-2水平单独及联合预测老年肺结核患者预后不良的曲线下面积(AUC)分别为0.847、0.743、0.810、0.954。HRCT评分、sTREM-1、HBD-2是老年肺结核患者预后不良的影响因素(P<0.05)。结论HRCT评分联合血清sTREM-1、HBD-2有望作为预测老年肺结核患者预后不良的标志物。Objective To explore the predictive value of high resolution CT(HRCT)score combined with serum triggering receptor expressed on myeloid cells-1(sTREM-1)and human beta-defensin 2(HBD-2)for the prognosis of elderly pulmonary tuberculosis patients.Methods A total of 132 elderly patients with pulmonary tuberculosis admitted to this hospital from May 2021 to May 2023 were included in the study group.According to prognosis,they were grouped into a good prognosis group of 96 cases and a poor prognosis group of 36 cases.Another 130 healthy individuals who underwent HRCT examination served as the control group.Enzyme linked immunosorbent assay(ELISA)was used to detect serum levels of sTREM-1 and HBD-2.Receiver operating characteristic(ROC)curve was applied to analyze the predictive value of HRCT score and serum levels of sTREM-1 and HBD-2 for poor prognosis in elderly pulmonary tuberculosis patients.Meanwhile,multivariate Logistic regression was used to analyze the factors affecting the poor prognosis of elderly pulmonary tuberculosis patients.Results The HRCT score and serum levels of sTREM-1 and HBD-2 in the study group were higher than those in the control group(P<0.05).The HRCT score,serum sTREM-1,and HBD-2 levels in the good prognosis group before treatment and 2,6 months after treatment showed a downward trend(P<0.05),with a time effect.The HRCT score,serum sTREM-1,and HBD-2 levels in the poor prognosis group were higher than those in the good prognosis group at 2 and 6 months after treatment(P<0.05),and there was an interactive effect between time and grouping factors.The area under the curve(AUC)for predicting poor prognosis in elderly pulmonary tuberculosis patients with HRCT score and serum sTREM-1 and HBD-2 levels alone and in combination were 0.847,0.743,0.810,and 0.954,respectively.HRCT score,sTREM-1,and HBD-2 were factors that affected the poor prognosis of elderly pulmonary tuberculosis patients(P<0.05).Conclusion The combination of HRCT score and serum sTREM-1 and HBD-2 is expected to serve as markers for

关 键 词：肺结核 高分辨率CT评分 可溶性髓系细胞触发受体-1 Β-防御素2 预后 

分 类 号：R521[医药卫生—内科学] R446.11[医药卫生—临床医学]