肺结核治疗过程中IL-6血清表达水平变化分析  

Analysis of changes in serum expression levels of IL-6 during pulmonary tuberculosis treatment

作　　者：谢贝[1,2] 许婉华 龚兰 杨瑜 董海平[2,4] 吴玲 孟繁荣 王楠[1,2] 刘志辉[1,2] 李华 XIE Bei;XU Wanhua;GONG Lan;YANG Yu;DONG Haiping;WU ling;MENG Fanrong;WANG Nan;LIU Zhihui;LI Hua(Institute of Pulmonary Diseases,Guangzhou Chest Hospital Guangzhou 510095,China;ICU of tuberculosis,Guangzhou Chest Hospital,Guangzhou 510095,China;不详)

机构地区：[1]广州市胸科医院肺部疾病研究所,广州510095 [2]呼吸疾病国家重点实验室,广州510095 [3]广州市结核病防治所二分所,广州510095 [4]广州市胸科医院重症结核科,广州510095

出　　处：《实用医学杂志》2023年第19期2434-2439,共6页The Journal of Practical Medicine

基　　金：广州市科技计划-重点研发项目(编号:202206010134);广州市卫生健康科技项目(编号:20231A011051);广州市科技计划(编号:202002030152,202201010744);广州市医学重点学科(编号:2021-2023)结核病学;国家重点研发计划“病原学与防疫技术体系研究”重点专项(编号:2022YFC2304800)。

摘　　要：目的探究血清中白介素-6(IL-6)水平在肺结核治疗过程中的变化趋势及影响因素。方法分别收集56位肺结核患者治疗前、治疗2个月(强化期结束)和治疗6个月时血清,通过流式细胞术测量其中IL-6的表达水平。结果肺结核患者治疗期间血清中IL-6的表达水平呈降低趋势,且其表达水平差异具有统计学意义(P=0.000)。ROC曲线分析显示,治疗前和治疗2个月时,血清中IL-6表达水平差异的线下面积为0.627,界值为3.840,鉴别的灵敏度为71.40%,特异度为51.80%。二元logistic回归显示治疗2个月后血清中IL-6表达水平是否降低至3.840 pg/mL以下与治疗周期、年龄有关。治疗前IL-6的血清表达水平在有无空洞组、治疗周期为6个月组和12个月组、治疗2个月时对比未治疗前影像学病灶吸收组和无明显变化组、治疗前病原学检查结果阴阳性组之间的差异具有统计学意义。治疗2个月时,IL-6的血清表达水平在不同年龄组、不同治疗周期组、治疗前及治疗2个月时病原学检查结果阴阳性组之间的差异具有统计学意义。治疗6个月时,IL-6的血清表达水平在是否有糖尿病组、不同治疗周期组、治疗6个月时病原学检查结果阴阳性组之间的差异具有统计学意义。ROC曲线分析显示,将入组病例限制到治疗前病原学阳性时,治疗6个月和治疗2个月血清中IL-6表达水平差异的线下面积为0.805,界值为5.450,鉴别的灵敏度为81.25%,特异度为75.00%;当将入组病例年龄限制到44岁及以下时,治疗2个月和治疗前、治疗6个月和治疗2个月血清中IL-6表达水平差异的线下面积分别为0.726、0.721,界值分别为3.840、3.755,鉴别的灵敏度均为70.59%,特异度分别为70.59%、67.65%。结论肺结核治疗过程中IL-6在血清中的表达水平呈下降趋势,其水平与患者肺部有无空洞、病原学结果、年龄、病情进展、是否合并糖尿病等有关。Objective To explore the trend and influencing factors of serum IL-6 level in the treatment of pulmonary tuberculosis.Methods The serum of 56 patients with pulmonary tuberculosis was collected before treatment,2 months of treatment(the end of the intensive period)and 6 months of treatment,and the expression level of IL-6 was measured by flow cytometry.Results The expression level of IL-6 in serum during treatment in tuberculosis patients tended to decrease,and the expression level was statistically significant(P=0.000).ROC curve analysis showed that before treatment and 2 months of treatment,the subline area of IL-6 concentration difference in serum was 0.627,the cut-off value was 3.840,the sensitivity for discrimination was 71.40%,and the specificity was 51.80%.Binary logistic regression showed that whether the serum IL-6 concentration decreased to less than 3.840 pg/mL after 2 months of treatment was related to treatment cycle and age.The difference between the serum concentration of IL-6 before treatment was statistically significant between the group with or without cavitation,the treatment period group with 6 months and 12 months,and the group with no significant change in imaging lesions before treatment at 2 months,and the negative group with positive etiological test results before treatment.At 2 months of treatment,the difference between serum concentrations of IL-6 was statistically significant between different age groups,different treatment cycle groups,and the group with negative etiological test results before treatment and at 2 months of treatment.At 6 months of treatment,the difference between the serum concentration of IL-6 was statistically significant in the group with diabetes,in the group with different treatment cycles,and in the group with negative etiological test results at 6 months of treatment.ROC curve analysis showed that when the enrolled cases were limited to positive etiology before treatment,the off-line area of the difference in serum IL-6 concentration between 6 months of treatm

关 键 词：肺结核 白介素-6 表达水平变化 

分 类 号：R521[医药卫生—内科学]