摘要
目的:探讨肺结核(PTB)患者血清颗粒蛋白前体(PGRN)、脂质运载蛋白2(LCN2)水平及其与病情严重程度的相关性。方法:选取2020年2月至2023年2月于本院就诊的127例肺结核患者,根据病情严重程度将其分为轻症组(n=78)和重症组(n=49),另选取同期体检健康者72例作为对照组。采用酶联免疫吸附法测定各组血清PGRN和LCN2水平;Spearman法分析血清PGRN和LCN2水平与Bandim结核病(TB)评分之间的相关性;多因素Logistic回归分析重症PTB发生的影响因素;绘制受试者工作特征(ROC)曲线分析血清PGRN和LCN2水平对重症PTB的诊断价值。结果:重症组血清PGRN和LCN2水平明显高于轻症组和对照组(P<0.05);重症组糖尿病史占比,Bandim TB评分,IL-10、IFN-γ、PCT、CRP水平明显高于轻症组(P<0.05);血清PGRN和LCN2水平与Bandim TB评分均呈正相关(r_(s)值分别为0.428、0.420,均P<0.001);PGRN(OR=1.576,95%CI:1.112~2.234)和LCN2(OR=2.163,95%CI:1.320~3.545)为重症PTB发生的危险因素(P<0.05);血清PGRN和LCN2水平联合诊断重症PTB的曲线下面积(AUC)为0.943,敏感度为91.84%,二者联合优于各自单独诊断(Z_(二者联合-PGRN)=2.327,P=0.020;Z_(二者联合-LCN2)=2.061,P=0.039)。结论:PTB患者血清PGRN和LCN2水平与Bandim TB评分呈正相关,二者血清水平与患者病情严重程度密切相关。
Objective:To investigate the levels of progranulin(PGRN)and lipocalin-2(LCN2)in the serum of patients with pulmonary tuberculosis(PTB)and their correlation with the severity of the disease.Methods:From February 2020 to February 2023,127 pulmonary tuberculosis patients who visited our hospital were regarded as the study subjects.They were separated into mild disease group(n=78)and severe disease group(n=49)based on the severity of the disease.Additionally,72 healthy individuals who underwent physical examination were regarded as the control group.Enzyme-linked immunosorbent assay(ELISA)was applied to determine the levels of serum PGRN and LCN2 in each group;Spearman method was applied to analyze the correlation between serum PGRN and LCN2 levels and Bandim TB score;multivariate Logistic regression was applied to analyze the influencing factors of severe PTB occurrence;receiver operating characteristic(ROC)curve was plotted to analyze the diagnostic value of serum PGRN and LCN2 levels for severe PTB.Results:The serum levels of PGRN and LCN2 in the severe group were obviously higher than those in the mild group and the control group(P<0.05);the proportion of diabetes history,Bandim TB score,IL-10,IFN-γ,PCT,CRP levels in severe group were obviously higher than those in mild group(P<0.05);the levels of serum PGRN and LCN2 were positively correlated with Bandim TB score(r_(s)=0.428,0.420,all P<0.001);PGRN(OR=1.576,95%CI=1.112-2.234)and LCN2(OR=2.163,95%CI=1.320-3.545)were risk factors for the occurrence of severe PTB(P<0.05);the area under the curve(AUC)of the combination of serum PGRN and LCN2 levels for diagnosing severe PTB was 0.943,with a sensitivity of 91.84%,the combination of the two was superior to individual diagnosis(Z_(combination-PGRN)=2.327,P=0.020;Z_(combination-LCN2)=2.061,P=0.039).Conclusion:The serum levels of PGRN and LCN2 in PTB patients are positively correlated with Bandim TB score,and their serum levels are closely related to the severity of disease.
作者
印薇薇
胡小芳
姜艳萍
YIN Weiwei;HU Xiaofang;JIANG Yanping(Department of Respiratory and Critical Care Medicine,Wuxi Fifth People's Hospital,Wuxi 214000,China;Department of Tuberculosis,Wuxi Fifth People's Hospital,Wuxi 214000,China)
出处
《东南大学学报（医学版）》
CAS
2024年第4期610-615,共6页
Journal of Southeast University(Medical Science Edition)
