CT评分及白细胞介素34、可溶性白细胞介素2受体对活动性肺结核的诊断及预后预测价值  

Value of CT score,IL-34 and SIL-2R in diagnosis and prognostic prediction for active tuberculosis

作　　者：王超逸 毛佳 陈露 WANG Chaoyi;MAO Jia;CHEN Lu(Department of Radiology,Wuhan Jinyintan Hospital,Wuhan 430040,China)

机构地区：[1]湖北省武汉市金银潭医院放射科,湖北武汉430040

出　　处：《中国中西医结合影像学杂志》2024年第3期306-310,共5页Chinese Imaging Journal of Integrated Traditional and Western Medicine

摘　　要：目的:探讨CT评分及白细胞介素34(IL-34)、可溶性白细胞介素2受体(SIL-2R)对活动性肺结核(ATB)的诊断价值及预后预测价值。方法:选取ATB患者2000例作为ATB组,同期选取500例非ATB患者为非ATB组。ATB组行抗结核治疗6个月,随访3年,其中预后不良538例和预后良好1462例。分析CT评分及IL-34、SIL-2R对ATB的诊断及预后预测价值。结果:ATB组CT评分、IL-34、SIL-2R均明显高于非ATB组(均P<0.05)。ROC曲线显示,CT评分、IL-34、SIL-2R及三者联合诊断ATB的AUC分别为0.859、0.820、0.876、0.932,CT评分最佳临界值对应的敏感度、特异度分别为64.2%、100.0%,IL-34为61.7%、100.0%,SIL-2R为72.7%、90.2%,三者联合为82.9%、90.6%。ATB组中预后不良患者的CT评分、IL-34、SIL-2R均明显高于预后良好患者(均P<0.05)。ROC曲线显示,CT评分、IL-34、SIL-2R、三者联合预测ATB预后不良的AUC分别为0.851、0.838、0.847、0.908,CT评分最佳临界值对应的敏感度、特异度分别为67.8%、90.1%,IL-34为54.8%、100.0%,SIL-2R为65.6%、88.4%,三者联合为84.8%、89.7%。结论:ATB患者CT评分、IL-34、SIL-2R呈高表达;预后越差,CT评分、IL-34、SIL-2R越高。CT评分、IL-34、SIL-2R三者联合对ATB具有较高的诊断价值及预后预测价值。Objective:To explore the diagnostic value and prognostic predictive value of CT score,interleukin-34(IL-34)and soluble interleukin-2 receptor(SIL-2R)in active tuberculosis(ATB).Methods:2000 ATB patients were selected as ATB group,and 500 patients without ATB during the same period were selected as the non-ATB group.ATB group were treated with anti-tuberculosis therapy for 6 months and followed up for 3 years,538 cases were with poor prognosis and 1462 cases with good prognosis.The diagnostic and prognostic value of CT score,IL-34,SIL-2R for ATB were analyzed.Results:The CT score,IL-34,and SIL-2R in the ATB group were significantly higher than those in the non-ATB group(all P<0.05).ROC curve showed that the AUCs of CT score,IL-34,SIL-2R and their combination in diagnosing ATB were 0.859,0.820,0.876 and 0.932,respectively.The sensitivity and specificity for the optimal critical value of CT score were 64.2%and 100.0%,those of IL-34 were 61.7%and 100.0%,those of SIL-2R were 72.7%and 90.2%,and those of their combination were 82.9%and 90.6%.The CT score,IL-34,and SIL-2R in ATB patients with poor prognosis were significantly higher than those in ATB patients with good prognosis(all P<0.05).ROC curve showed that the AUCs of CT score,IL-34,SIL-2R and their combination to predict poor prognosis were 0.851,0.838,0.847 and 0.908,respectively.The sensitivity and specificity for the optimal critical value of CT score were 67.8%and 90.1%,those of IL-34 were 54.8%and 100.0%,those of SIL-2R were 65.6%and 88.4%,and those of the combination were 84.8%and 89.7%.Conclusions:The CT score,IL-34 and SIL-2R of ATB patients are highly expressed.The poorer the prognosis,the higher the CT score,IL-34 and SIL-2R.The combination of CT score,IL-34 and SIL-2R has a high diagnostic value and predictive value for ATB.

关 键 词：体层摄影术 X线计算机 白细胞介素34 可溶性白细胞介素2受体 活动性肺结核 诊断 预后 

分 类 号：R521[医药卫生—内科学]