miRNA-99b、LL-37、IP-10在耐多药肺结核患者中表达及早期疗效预测价值  

The expression and early efficacy prediction value of miRNA-99b, LL-37, and IP-10 in multidrug-resistant pulmonary tuberculosis patients

作　　者：周贵忠 黄远江 翁敏华 张振云 ZHOU Guizhong;HUANG Yuanjiang;WENG Minhua;ZHANG Zhenyun(Department of Infectious and Tropical Diseases,The Second Affiliated Hospital of Hainan Medical University,Haikou,Hainan 570216,China)

机构地区：[1]海南医学院第二附属医院感染病与热带病科,海南海口570216

出　　处：《临床肺科杂志》2025年第1期92-97,共6页Journal of Clinical Pulmonary Medicine

基　　金：海南省医药卫生科研项目(No.2003196)。

摘　　要：目的 分析微小RNA-99b(miRNA-99b)、抗菌肽LL-37、干扰素-γ诱导蛋白10(IP-10)在耐多药肺结核(MDR-PTB)患者中表达及早期疗效预测价值。方法 研究纳入医院2022年11月-2024年2月临床收治MDR-PTB患者108例为MDR-PTB组,Bandim TBscore评分法将其划分为轻度组(n=71)与中-重度组(n=37);纳入同期非耐药肺结核患者(DS-PTB)87例为DS-PTB组,健康体检志愿者90例为健康对照组,检测、评估组间miRNA-99b、LL-37、IP-10表达水平及治疗8周后临床疗效,采用Pearson评估miRNA-99b、LL-37、IP-10表达水平与MDR-PTB患者临床疗效相关性,指标预测价值行多因素Logistic回归,作ROC曲线分析模型预测价值。结果 MDR-PTB组miRNA-99b、LL-37、IP-10均高于DS-PTB组与健康对照组(P<0.05),且DS-PTB组miRNA-99b、LL-37、IP-10高于健康对照组(P<0.05);MDR-PTB组内,中-重度组miRNA-99b、LL-37、IP-10表达水平均高于轻度组(P<0.05);治疗4周、治疗8周后,MDR-PTB患者miRNA-99b、LL-37、IP-10均低于治疗前(P<0.05);108例MDR-PTB患者经8周治疗后临床有效率为88.89%;miRNA-99b、LL-37、IP-10均与有效率呈负相关关系(r=-0.693、-0.706、-0.497,P<0.05);miRNA-99b、LL-37、IP-10高水平表达为MDR-PTB发生发展独立危险因素,有统计学意义(P<0.05),ROC曲线分析显示,miRNA-99b、LL-37、IP-10联合检测AUC为0.937(95%CI:0.863~0.974)高于单一检测结果(Z=7.691、7.069、8.068,P均<0.001);且联合检测敏感度(96.91%)与特异度(96.34%)均最高。结论 miRNA-99b、LL-37、IP-10高水平表达参与MDR-PTB发生与发展,三项联合在MDR-PTB患者早期疗效预测中应用价值高。Objective To analyze the expression of micro RNA-99B(miRNA-99b),antimicrobial peptide LL-37,interferon-gamma-induced protein 10(IP-10)in patients with multidrug-resistant pulmonary tuberculosis(MDR-PTB)and the value of early curative effect prediction.Methods A total of 108 MDR-PTB patients admitted to the hospital from November 2022 to February 2024 were classified as MDR-PTB group and were divided into mild group(n=71)and moderate to severe group(n=37)by Bandim TBscore.Eighty-seven patients with non-drug-resistant tuberculosis(DS-TB)were included in the DS-TB group and 90 healthy volunteers were included in the healthy control group.The expression levels of miRNA-99b,LL-37,and IP-10 between the groups were detected and evaluated,and the clinical efficacy after 8 weeks of treatment was also evaluated.Pearson was used to evaluate the correlation between the expression levels of miRNA-99b,LL-37,and IP-10 and the clinical efficacy of MDR-PTB patients.The predictive value of indicators was evaluated by multivariate Logistic regression,and the predictive value of the ROC curve analysis model was performed.Results The miRNA-99b,LL-37,and IP-10 levels in the MDR-PTB group were higher than those in the DS-TB group and healthy control group(P<0.05),and the miRNA-99b,LL-37,and IP-10 levels in the DS-TB group were higher than those in the healthy control group(P<0.05);In the MDR-PTB group,the expression levels of miRNA-99b,LL-37,and IP-10 in the moderate to the severe group were higher than those in the mild group(P<0.05);After 4 weeks of treatment and 8 weeks of treatment,the miRNA-99b, LL-37, and IP-10 levels in MDR-PTB patients were lower than before treatment ( P <0.05);After 8 weeks of treatment, the clinical effective rate of 108 MDR-PTB patients was 88.89%;MiRNA-99b, LL-37, and IP-10 are all negatively correlated with efficacy ( r =-0.693, -0.706, -0.497, P <0.05);High levels of expression of miRNA-99b, LL-37, and IP-10 were independent risk factors for the occurrence and development of MDR-PTB, with statistical sig

关 键 词：miRNA-99b LL-37 IP-10 耐多药肺结核 早期疗效 预测价值 

分 类 号：R521[医药卫生—内科学]