外周血IFN-γ、PCT及OPN水平对活动性肺结核的诊断价值及其与抗结核治疗预后的相关性分析  

Diagnostic value of peripheral blood IFN-γ,PCT and OPN levels on active pulmonary tuberculosis and their correlation with the prognosis of anti-tuberculosis treatment

作　　者：王若涛 吴敏校 杨虹 陈宗云 WANG Ruo-tao;WU Min-xiao;YANG Hong(Laboratory Department,Mindong Hospital Affiliated to Fujian Medical University,Fu'an 355000,China)

机构地区：[1]福建医科大学附属闽东医院检验科,355000

出　　处：《中国现代药物应用》2024年第19期10-15,共6页Chinese Journal of Modern Drug Application

摘　　要：目的探讨外周血γ-干扰素(IFN-γ)、降钙素原(PCT)及骨桥蛋白(OPN)水平对活动性肺结核的诊断价值及其与抗结核治疗预后的相关性。方法选取210例活动性肺结核患者作为活动性肺结核组,选择同期60例健康体检者作为健康对照组。对活动性肺结核患者予以2HRZE/4HR方案进行抗结核治疗。根据患者是否治愈将活动性肺结核患者分为治愈组(161例)和未治愈组(49例)。比较活动性肺结核组治疗前与健康对照组血清IFN-γ、PCT及OPN水平,基于IFN-γ、PCT及OPN构建活动性肺结核的二元Logistic回归分析及联合诊断模型,分析IFN-γ、PCT、OPN单独及联合诊断模型的预测效能,比较治愈组和未治愈组患者治疗前后血清IFN-γ、PCT及OPN水平,分析活动性肺结核患者治疗前血清IFN-γ、PCT及OPN水平与治疗预后的相关性。结果活动性肺结核组患者治疗前血清IFN-γ、PCT及OPN水平分别为(23.20±10.01)pg/ml、(1.46±0.60)ng/ml、(721.79±303.62)ng/ml,明显高于健康对照组的(5.69±2.74)pg/ml、(0.25±0.11)ng/ml、(171.99±68.53)ng/ml,差异具有统计学意义(P<0.05)。将研究对象血清IFN-γ、PCT及OPN水平作为自变量,以是否为活动性肺结核为因变量,行二元Logistic回归分析。结果表明,血清IFN-γ[OR=2.000,95%CI=(1.215,3.294)]、PCT[OR=1.023,95%CI=(1.005,1.042)]及OPN[OR=1.049,95%CI=(1.008,1.092)]水平升高是活动性肺结核的独立危险因素(P<0.05)。最终模型公式为P=1/[1+e^(-19.197+0.693×IFN-γ+0.0230×PCT+0.048×OPN)]。受试者工作特征曲线(ROC曲线)分析显示,IFN-γ、PCT及OPN预测活动性肺结核的曲线下面积(AUC)分别为0.797、0.637和0.756,IFN-γ的敏感度和特异度分别为62.9%和93.3%,OPN的敏感度和特异度分别为53.3%和91.7%,PCT的敏感度和特异度分别为51.0%和85.0%。联合上述指标的二元Logistic回归模型预测活动性肺结核的AUC为0.892,敏感度和特异度分别为76.2%和98.3%,模型整体的诊断效能优于单独�Objective To explore the diagnostic value of peripheral blood interferon-γ(IFN-γ),procalcitonin(PCT)and osteopontin(OPN)levels on active pulmonary tuberculosis and their correlation with the prognosis of anti-tuberculosis treatment.Methods 210 patients with active pulmonary tuberculosis were selected as the active pulmonary tuberculosis group,and 60 healthy subjects during the same period were selected as the healthy control group.The levels of IFN-γ,PCT and OPN in peripheral blood were compared between the two groups.Patients with active pulmonary tuberculosis were given 2HRZE/4HR regimen for anti-tuberculosis treatment.Patients were divided into cured group(161 cases)and uncured group(49 cases)according to whether they were cured or not.Serum IFN-γ,PCT and OPN levels were compared between the active pulmonary tuberculosis group before treatment and the healthy control group.Binary Logistic regression analysis and combined diagnostic model of active pulmonary tuberculosis were constructed based on IFN-γ,PCT and OPN,and the predictive efficacy of single and combined diagnostic models of IFN-γ,PCT and OPN were analyzed.Serum levels of IFN-γ,PCT and OPN before and after treatment were compared between cured group and untreated group.The correlation between serum IFN-γ,PCT and OPN levels before treatment and the prognosis of treatment was analyzed in patients with active pulmonary tuberculosis.Results Serum IFN-γ,PCT and OPN levels of active pulmonary tuberculosis group were(23.20±10.01)pg/ml,(1.46±0.60)ng/ml and(721.79±303.62)ng/ml before treatment,which were significantly higher than(5.69±2.74)pg/ml,(0.25±0.11)ng/ml and(171.99±68.53)ng/ml of healthy control group,and the difference was statistically significant(P<0.05).Binary Logistic regression analysis was performed with serum IFN-γ,PCT and OPN levels of the study subjects as independent variables and the presence of active tuberculosis as dependent variable.The results showed that elevated levels of serum IFN-γ[OR=2.000,95%CI=(1.215,3.294)],PCT

关 键 词：活动性肺结核 Γ-干扰素 降钙素原 骨桥蛋白 诊断价值 预后 

分 类 号：R521[医药卫生—内科学]