肺结核患者血清抗菌肽LL-37及血红素加氧酶-1水平变化及其与病情严重程度的相关性  

Changes in serum antimicrobial peptide ll-37 and heme oxygenase-1 levels in pulmonary tuberculosis patients and their correlation with the severity of the disease

作　　者：刘岩 王隽[2] 张嘉麟 邵书鹏 LIU Yan;WANG Jun;ZHANG Jialin;SHAO Shupeng(Department of Tuberculosis,Jiamusi Tuberculosis Hospital(Jiamusi Tumor Hospital),154004,China)

机构地区：[1]佳木斯市结核病医院(佳木斯市肿瘤医院)结核一科,154004 [2]首都医科大学附属北京胸科医院结核科,101125

出　　处：《传染病信息》2025年第1期37-41,共5页Infectious Disease Information

摘　　要：目的探讨肺结核患者血清抗菌肽LL-37、血红素加氧酶-1(heme oxygenase-1,HO-1)水平变化及其与病情严重程度的相关性。方法选取2022年5月至2024年5月在佳木斯市结核病医院就诊的94例肺结核患者作为肺结核组,并根据病情严重程度分为轻症组(n=56)和重症组(n=38),另选取89例同期进行体检的健康者作为对照组。采用酶联免疫吸附测定法检测血清LL-37、HO-1的水平。用Logistic回归分析患者发生重症肺结核的影响因素。用受试者工作特征(receiver operating characteristic,ROC)曲线分析血清LL-37、HO-1水平对肺结核病情程度的诊断价值。结果与对照组相比,肺结核组血清LL-37水平显著降低,血清HO-1水平显著升高(P均<0.05);重症组血清HO-1和CRP、IFN-γ水平显著高于轻症组,血清LL-37水平显著低于轻症组(P均<0.05)。肺结核患者抗痨治疗之后血清LL-37水平显著升高,血清HO-1水平显著降低(P均<0.05)。Logistic回归分析结果显示,CRP、IFN-γ、HO-1水平升高是影响重症肺结核发生的危险因素,LL-37水平降低是影响重症肺结核发生的危险因素(P均<0.05);血清LL-37、HO-12者联合诊断肺结核病情程度的曲线下面积为0.904,2者联合优于各自单独诊断。结论肺结核患者血清LL-37水平降低,HO-1水平升高,2者与病情程度密切相关,联合检测对发生肺结核的病情程度具有较高的临床诊断价值。Objective To investigate the changes in serum antimicrobial peptide LL-37 and heme oxygenase-1(HO-1)levels in pulmonary tuberculosis patients and their correlation with the severity of the disease.Methods Ninety-four patients with pulmonary tuberculosis who attended Jiamusi Tuberculosis Hospital from May 2022 to May 2024 were selected as the tuberculosis group,and were assigned into mild group(n=56)and severe group(n=38)according to the severity of the disease.Additionally,89 healthy individuals who underwent physical check ups were included as the control group.Enzyme linked immunosorbent assay(ELISA)was applied to detect the levels of serum LL-37 and HO-1.Logistic regression was applied to analyze the influencing factors of severe pulmonary tuberculosis in patients.Receiver operating characteristic(ROC)curve was used to analyze the diagnostic value of serum LL-37 and HO-1 levels for the severity of pulmonary tuberculosis.Results Serum LL-37 levels were significantly lower and serum HO-1 levels were significantly higher in the tuberculosis group compared with the control group(P<0.05).Serum HO-1 and CRP and IFN-γwere significantly higher in the severe group than in the mild group,while the serum LL-37 was prominently lower than that in the mild group(P<0.05).Serum LL-37 levels were significantly higher and serum HO-1 levels were significantly lower after treatment in the tuberculosis group of patients(P<0.05).Elevated levels of CRP,IFN-γ,and HO-1 are risk factors for the development of severe tuberculosis,and decreased levels of LL-37 are risk factors for the development of severe tuberculosis(P<0.05).The AUC of serum LL-37 and HO-1 in the combined diagnosis of pulmonary tuberculosis was 0.904,which was better than their respective diagnosis.Conclusion Serum LL-37 level is decreased and HO-1 level is increased in pulmonary tuberculosis patients.Both are closely related to the severity of the disease,and combined detection has high clinical diagnostic value for the severity of pulmonary tuberculosis.

关 键 词：肺结核 抗菌肽LL-37 血红素加氧酶-1 

分 类 号：R521[医药卫生—内科学]