IL-33联合异常淋巴细胞比例及焦痂情况对恙虫病的诊断价值  

Diagnostic value of IL-33 combined with abnormal lymphocyte proportion and eschar condition for tsutsugamushi disease

作　　者：董莎莎 詹步同 吴张茜 刘传苗 DONG Shasha;ZHAN Butong;WU Zhangqian;LIU Chuanmiao(Department of Infectious Diseases,the First Affiliated Hospital of Bengbu Medical University,Bengbu,Anhui 233030,China;National Clinical Research Center for Infectious Diseases Core Cooperative Unit,Bengbu,Anhui 233030,China;Anhui Provincial Key Laboratory of Basic and Clinical Immunology of Chronic Diseases,Bengbu,Anhui 233030,China)

机构地区：[1]蚌埠医科大学第一附属医院感染科,安徽蚌埠233030 [2]国家感染性疾病临床医学研究中心核心合作单位,安徽蚌埠233030 [3]慢性疾病免疫学基础与临床安徽省重点实验室,安徽蚌埠233030

出　　处：《检验医学与临床》2024年第22期3300-3304,共5页Laboratory Medicine and Clinic

基　　金：安徽省教育厅高校科学研究项目(重大项目,KJ2021ZD0081);蚌埠医学院科技项目(2021byzd084)。

摘　　要：目的探讨血清白细胞介素(IL)-33、异常淋巴细胞比例及焦痂情况对恙虫病的诊断价值。方法选取2022年1月至2023年12月因发热就诊于蚌埠医科大学第一附属医院的81例患者作为研究对象,根据IgM/IgG检测结果分为恙虫病组(38例)和非恙虫病组(43例)。采用酶联免疫吸附试验检测两组血清IL-33水平。采用多因素Logistic回归分析恙虫病的影响因素。采用受试者工作特征(ROC)曲线分析血清IL-33、异常淋巴细胞比例及焦痂情况对恙虫病的诊断价值。结果恙虫病组IL-33水平、异常淋巴细胞比例、焦痂发生率均高于非恙虫病组,差异均有统计学意义(P<0.05);多因素Logistic回归分析结果显示,IL-33水平、异常淋巴细胞比例及焦痂情况是恙虫病的影响因素(P<0.05);ROC曲线分析结果显示,IL-33水平、异常淋巴细胞比例、焦痂情况联合检测诊断恙虫病的曲线下面积(AUC)为0.949,灵敏度为100.00%,特异度为76.74%,3项联合检测诊断恙虫病的AUC高于各项指标单独检测。结论IL-33水平、异常淋巴细胞比例及焦痂情况可作为诊断恙虫病的有效指标,3项联合检测可提高诊断效能。Objective To investigate the diagnostic value of serum interleukin(IL)-33,abnormal lymphocyte proportion and eschar status for tsutsugamushi disease.Methods A total of 81 patients who were admitted to the First Affiliated Hospital of Bengbu Medical University due to fever from January 2022 to December 2023 were selected as the research objects.According to the detection results of IgM/IgG,they were divided into tsutsugamushi disease group(38 cases)and non-tsutsugamushi disease group(43 cases).The serum level of IL-33 in the two groups were detected by enzyme linked immunosorbent assay.Multivariate Logistic regression was used to analyze the influencing factors of scrub typhus.The receiver operating characteristic(ROC)curve was used to analyze the diagnostic value of serum IL-33,the proportion of abnormal lymphocytes and eschar status for tsutsugamushi disease.Results The level of IL-33,the proportion of abnormal lymphocytes and the incidence of eschar in the tsutsugamushi disease group were significantly higher than those in the non-tsutsugamushi disease group(P<0.05).The results of multivariate Logistic regression analysis showed that the level of IL-33,the proportion of abnormal lymphocytes and the condition of eschar were the influencing factors of tsutsugamushi disease(P<0.05).The results of ROC curve analysis showed that the area under the curve(AUC)of combined detection of IL-33 level,proportion of abnormal lymphocytes and eschar condition in the diagnosis of scrub typhus was 0.949,the sensitivity was 100.00%,and the specificity was 76.74%.The AUC of combined detection of the three in the diagnosis of tsutsugamushi disease was higher than that of each individual detection.Conclusion IL-33 level,abnormal lymphocyte proportion and eschar condition can be used as effective indicators for the diagnosis of tsutsugamushi disease,and the combined detection of the three can improve the diagnostic efficiency.

关 键 词：恙虫病 白细胞介素-33 异常淋巴细胞比例 焦痂情况 诊断价值 

分 类 号：R513[医药卫生—内科学] R446.1[医药卫生—临床医学]