IFN-γ和IL-2联合检测在老年糖尿病患者中肺结核辅助诊断价值  

Value of IFN-γand IL-2 combined detection in the auxiliary diagnosis of pulmonary tuberculosis in elderly patients with diabetes

作　　者：曹兆兰[1] 王珊珊 李勇[1] 张姗姗 孙梦 徐建春[1] CAO Zhaolan;WANG Shanshan;LI Yong;ZHANG Shanshan;SUN Meng;XU Jianchun(Department of Tuberculosis,Lianyungang Fourth People′s Hospital,Lianyungang,Jiangsu 222000,China)

机构地区：[1]连云港市第四人民医院结核科,江苏连云港222000

出　　处：《临床肺科杂志》2024年第12期1862-1865,共4页Journal of Clinical Pulmonary Medicine

摘　　要：目的评估结核特异性细胞因子IFN-γ和IL-2(双因子)联合检测在老年糖尿病患者中肺结核辅助诊断的的应用价值。方法回顾性分析2023年10月-2024年2月在连云港市第四人民医院收治的190例≥60周岁糖尿病且疑似肺结核患者的临床资料,根据临床诊断结果,其中老年糖尿病患者中合并肺结核患者103例(DM-TB组)、非结核患者87例(对照组)。所有参与者均行痰涂片抗酸染色、结核培养、结核分子检测、IFN-γ和IL-2双因子联合检测,并对检测结果进行分析。结果DM-TB组IFN-γ和IL-2的平均值分别为(242.48±292.96)pg/mL、(158.19±162.85)pg/mL,与对照组的IFN-γ和IL-2的平均值(8.52±19.93)pg/mL、(5.79±10.29)pg/mL相比具有显著差异(P<0.001);双因子联合检测在老年糖尿病患者中肺结核辅助诊断的灵敏度、特异度分别为84.5%、82.8%,准确度为83.7%,引入IL-2作为诊断标志物,相较于单检IFN-γ,灵敏度提高了5.8%;调整IFN-γ和IL-2的最佳阈值为72.990 pg/mL、19.465 pg/mL时,双因子联合检测在老年糖尿病患者中结核病辅助诊断的AUC值为0.918。结论双因子联合检测对老年糖尿病合并肺结核患者的辅助诊断具有较高的价值。Objective To evaluate the value of combined detection of tuberculosis-specific cytokines IFN-γand IL-2(double factors)in the auxiliary diagnosis of pulmonary tuberculosis in elderly patients with diabetes.Methods The clinical data of 190 patients with diabetes mellitus≥60 years old and suspected tuberculosis admitted to the Fourth People′s Hospital of Lianyungang City from October 2023 to February 2024 were retrospectively analyzed.According to the clinical diagnosis results,103 elderly diabetic patients were complicated with tuberculosis(DM-TB group)and 87 non-tuberculosis patients(control group).All participants underwent sputum smear acid-fast staining,tuberculosis culture,tuberculosis molecular detection,IFN-γ,and IL-2 dual factor combined detection,and the detection results were analyzed.Results The mean values of IFN-γand IL-2 in the DM-TB group were(242.48±292.96)pg/mL and(158.19±162.85)pg/mL,respectively.The average values of IFN-γand IL-2 in the control group were 8.52±19.93 pg/mL and 5.79±10.29 pg/mL respectively(P<0.001).The sensitivity and specificity of two-factor combined detection in the auxiliary diagnosis of pulmonary tuberculosis in elderly diabetic patients were 84.5%,82.8%,and the accuracy was 83.7%,respectively.The introduction of IL-2 as a diagnostic marker increased the sensitivity by 5.8%compared with IFN-γalone.When the optimal thresholds of IFN-γand IL-2 were adjusted to 72.990 pg/mL and 19.465 pg/mL,the AUC value of the combined two-factor test in the auxiliary diagnosis of tuberculosis in elderly diabetic patients was 0.918.Conclusion The dual factor combined detection has a high value in the auxiliary diagnosis of elderly diabetes patients with pulmonary tuberculosis.

关 键 词：老年 糖尿病 肺结核 联合检测 

分 类 号：R587.1[医药卫生—内分泌] R521[医药卫生—内科学]