CRP、PCT、IFN-γ、IL-6及IFN-γ/IL-10的联合检测对HIV/TB双重感染的临床早期诊断价值  

Value of combined detection of CRP,PCT,IFN-γ,IL-6 and IFN-γ/IL-10 in early clinical diagnosis of HIV/TB co-infection

作　　者：高雯琬 周奉 李佩波 付晓[3] 魏成丽 王鹏森[1] 何瑛[1] 李同心[1] GAO Wenwan;ZHOU Feng;LI Peibo;FU Xiao;WEI Chengli;WANG Pengsen;HE Ying;LI Tongxin(Department of Central Laboratory,Chongqing Public Health Medical Center,Chongqing 400000,China;Department of Tuberculosis,Chongqing Public Health Medical Center,Chongqing 400000,China;Department of Laboratory Medicine,Chongqing Public Health Medical Center,Chongqing 400000,China)

机构地区：[1]重庆市公共卫生医疗救治中心中心实验室,重庆400036 [2]重庆市公共卫生医疗救治中心结核科,重庆400036 [3]重庆市公共卫生医疗救治中心医学检验科,重庆400036

出　　处：《国际检验医学杂志》2024年第20期2491-2495,共5页International Journal of Laboratory Medicine

基　　金：重庆市科卫联合医学科研项目(2024MSXM061);重庆市沙坪坝区技术创新与应用发展项目(202316);重庆市沙坪坝区技术创新与应用发展项目(202321)。

摘　　要：目的评估人类免疫缺陷病毒(HIV)感染者、结核病(TB)患者和HIV/TB双重感染者中C反应蛋白(CRP)、降钙素原(PCT)和细胞因子[干扰素-γ(IFN-γ)、肿瘤坏死因子-α(TNF-α)、白细胞介素(IL)-10、IL-6、IL-4、IL-2、IL-17A和IFN-γ/IL-10]表达差异,以期为临床早期判断HIV感染者是否具有HIV/TB双重感染提供依据。方法收集2021年1月至2022年9月在该中心就诊的103例HIV感染者(HIV组)、42例TB患者(TB组)和67例HIV/TB双重感染者(HIV/TB组)的病历资料和临床信息。所有患者均进行CRP、PCT和细胞因子检测,分析其在3组间的表达差异,绘制受试者工作特征(ROC)曲线并评价其筛查能力。结果与HIV组和TB组比较,HIV/TB组CRP、PCT、IFN-γ、IL-10、IL-6水平及IFN-γ/IL-10升高,差异均有统计学意义(P<0.001)。Bonferroni校正结果显示,CRP、PCT、IFN-γ、IL-6水平和IFN-γ/IL-10在HIV组和HIV/TB组中差异有统计学意义(均P<0.001)。ROC曲线分析显示,CRP、PCT、IFN-γ、IL-6和IFN-γ/IL-10联合检测的曲线下面积为0.826,均高于单一指标检测的AUC。结论CRP、PCT、IFN-γ、IL-6、IFN-γ/IL-10联合检测可以帮助临床早期筛查HIV感染者和HIV/TB双重感染者。Objective To evaluate the expression differences of C-reactive protein(CRP),procalcitonin(PCT)and cytokines[interferon-γ(IFN-γ),tumor necrosis factor-α(TNF-α),interleukin(IL)-10,IL-6,IL-4,IL-2,IL-17A,and IFN-γ/IL-10]in human immunodeficiency virus(HIV)infection,tuberculosis(TB)infection and HIV/TB co-infection in order to provide evidence for early clinical diagnosis of HIV/TB co-infection.Methods Medical records and clinical information of 103 patients with HIV(HIV group),42 patients with TB(TB group)and 67 patients with HIV/TB co-infection(HIV/TB group)were collected from January 2021 to September 2022.CRP,PCT and cytokines were detected in all patients,and their expression differences among the three groups were analyzed.Receiver operating characteristic(ROC)curves were drawn and screening ability was evaluated.Results Compared with HIV group and TB group,CRP,PCT,IFN-γ,IL-10,IL-6 levels and IFN-γ/IL-10 in HIV/TB group were increased,with statistical significance(P<0.001).Bonferroni correction results showed that CRP,PCT,IFN-γ,IL-6 levels and IFN-γ/IL-10 were significantly different between HIV and HIV/TB groups(all P<0.001).ROC curve analysis showed that the area under the curve of CRP,PCT,IFN-γ,IL-6 and IFN-γ/IL-10 combined detection was 0.826,which was higher than that of single detection.Conclusion CRP,PCT,IFN-γ,IL-6,IFN-γ/IL-10 combined detection can help the early screening of HIV infection and HIV/TB co-infection.

关 键 词：C反应蛋白 降钙素原 细胞因子 人类免疫缺陷病毒 结核病 

分 类 号：R446.1[医药卫生—诊断学]