摘要
目的本研究旨在探讨白细胞衍生趋化因子2(LECT2)和人类软骨糖蛋白39(YKL-40)在人类免疫缺陷病毒/获得性免疫缺陷综合征(HIV/AIDS)患者诊断结核病中的潜在价值。评估这些生物标志物预测结核病的表现,为临床提供更为精确的诊断工具。方法本研究为回顾性分析。选取2021年2月至2023年2月陕西省核工业二一五医院收治的84例HIV/AIDS合并结核病患者为研究组,另选取同期未合并结核病的HIV/AIDS患者92例为对照组。研究组男57例、女27例,年龄(47.69±10.59)岁;对照组男64例、女28例,年龄(48.22±9.46)岁。研究组84例患者持续抗结核治疗6个月后,分为预后不良组31例、预后良好组53例。比较患者的LECT2和YKL-40水平,通过受试者操作特征曲线(ROC)验证其对HIV/AIDS患者合并结核病的诊断价值。运用多因素logistic回归分析识别HIV/AIDS合并结核病患者预后不良的独立危险因素。结果研究组LECT2水平低于对照组[(20.65±3.38)μg/L比(22.67±3.34)μg/L]、YKL-40水平高于对照组[(159.54±17.56)μg/L比(148.74±18.74)μg/L],差异均有统计学意义(t=3.995、3.935,均P<0.001)。LECT2和YKL-40对HIV/AIDS患者合并结核病的联合诊断曲线下面积(AUC)为0.739(95%CI 0.665~0.812),灵敏度为79.8%,特异度为58.7%。多因素logistic回归分析结果表明,抗HIV治疗、HIV感染时间、CD4+T细胞和LECT2水平均是判断HIV/AIDS合并结核病患者预后的重要因素(均P<0.05)。采用ROC对LECT2的预后价值进行评估,结果表明,LECT2评估预后的AUC为0.657,灵敏度为64.5%,特异度为67.9%。结论LECT2和YKL-40水平的显著升高与HIV/AIDS患者合并结核病密切相关,可作为一种有效的生物标志物用于辅助诊断。
Objective To explore the potential value of leukocyte cell-derived chemotaxin 2(LECT2)and human cartilage glycoprotein-39(YKL-40)in the diagnosis of tuberculosis in patients with human immunodeficiency virus/acquired immunodeficiency syndrome(HIV/AIDS),assess the performance of these biomarkers in predicting tuberculosis,and provide more precise diagnostic tools for clinical use.Methods From February 2021 to February 2023,84 HIV/AIDS patients with tuberculosis admitted to No.215 Hospital of Shaanxi Nuclear Industry were selected as a study group,and 92 HIV/AIDS patients without tuberculosis during the same period were selected as a control group.There were 57 males and 27 females in the study group,aged(47.69±10.59)years.There were 64 males and 28 females in the control group,aged(48.22±9.46)years.Blood samples were collected to measure the levels of LECT2 and YKL-40.The diagnostic value of the two markers for tuberculosis in HIV/AIDS patients was verified by the receiver operating characteristic curve(ROC).Multivariate logistic regression analysis was used to identify independent risk factors for poor prognosis in HIV/AIDS patients with tuberculosis.Results The level of LECT2 in the study group was lower than that in the control group[(20.65±3.38)μg/L vs.(22.67±3.34)μg/L],and the level of YKL-40 was higher than that in the control group[(159.54±17.56)μg/L vs.(148.74±18.74)μg/L],with statistically significant differences(t=3.995 and 3.935,both P<0.001).The area under the curve(AUC)of combined diagnosis of LECT2 and YKL-40 for tuberculosis in HIV/AIDS patients was 0.739(95%CI 0.665-0.812),with a sensitivity of 79.8%and a specificity of 58.7%.Multivariate logistic regression analysis showed that anti-HIV treatment,duration of HIV infection,CD4+T cells,and LECT2 level were important factors for judging the prognosis of HIV/AIDS patients with tuberculosis(all P<0.05).ROC was used to evaluate the prognostic value of LECT2,and the results showed that the AUC of LECT2 was 0.657,with a sensitivity of 64.5%and a
作者
方珊
赵虎
王欣
王婵
谈方方
杨梦
杨欢欢
Fang Shan;Zhao Hu;Wang Xin;Wang Chan;Tan Fangfang;Yang Meng;Yang Huanhuan(Clinical Laboratory,No.215 Hospital of Shaanxi Nuclear Industry,Xianyang 712000,China;Department of Components,Xi'an Central Blood Station,Xi'an 710061,China)
出处
《国际医药卫生导报》
2024年第22期3796-3800,共5页
International Medicine and Health Guidance News
基金
陕西省自然科学基础研究计划(2022JQ-950)。
