关键词: 结核, 肺, 炎症趋化因子类, 受体, CXCR3, 酶联免疫吸附测定, 诊断, 鉴别

Abstract:

Objective To evaluate the value of CXCR3 ligand in the diagnosis of active pulmonary tuberculosis.Methods 106 patients with active pulmonary tuberculosis (PTB)(including 31 patients with sputum smear acid-fast staining negative, 39 patients with sputum smear acid-fast staining +~++, 36 patients with sputum smear acid-fast staining +++~++++), 89 patients with lung malignant tumors (PMT)(12 cases of small cell lung cancer, 37 cases of adenocarcinoma, 35 cases of squamous cell carcinoma, 3 cases of large cell carcinoma and 2 cases of neuroendocrine carcinoma), 82 patients with other pulmonary benign disease (PBD)(36 cases of secondary infection of bronchiectasis, 13 cases of lung abscess, 15 cases of fungal infection, 12 cases of mycoplasma infection, 6 cases of hamartoma), and 90 healthy controls (HC) were selected in Hebei Provincial Chest Hospital from March 2018 to December 2018. Serum interferon-γ (IFN-γ) and CXCR3 ligands (IFN-γ induced mononuclear factor (CXCL9),IFN-γ-inducible protein 10 (CXCL10), and IFN-inducible T-cell α chemoattractant (CXCL11)) were determined by ELISA.Results The contents of CXCL9, CXCL10 and CXCL11 in PTB group were (650.28 (220.00,881.21) pg/ml, 390.00 (200.05,500.29) pg/ml, 150.33 (80.12,320.00) pg/ml) which had statistical significance when compared with those (120.21 (33.50, 244.28) pg/ml, 58.00 (30.25, 85.56) pg/ml, 35.52 (20.27, 44.50) pg/ml) in PMT group (χ ² values were 124.21, 155.03, 118.68; P values were 0.000), and compared with those (45.52 (15.25, 86.55) pg/ml, 55.56 (26.75, 86.28) pg/ml, 31.53 (20.50, 45.25) pg/ml) in PBD group (χ ² values were 194.93, 159.84, 124.71; P values were 0.000), and compared with those (50.11 (28.32, 81.22) pg/ml, 50.28 (32.27, 70.62) pg/ml, 11.46 (5.28, 30.39) pg/ml) in HC group (χ ² values were 184.68, 183.53, 208.18; P values were 0.000). IFN-γ in PTB group (13.00 (8.50, 18.25) pg/ml) had no statistical significance when compared with those (15.11 (8.50,18.00) pg/ml) in PMT group (χ ²=10.05, P=0.509), and compared with those (13.02 (9.90, 18.28) pg/ml) in PBD group (χ ²=1.17, P=0.940). IFN-γ in PTB group had statistical significance compared with those (10.86 (7.01, 12.00) pg/ml) in HC group (χ ²=80.19, P=0.000). The area under curves (AUC) of CXCL9, CXCL10 and CXCL11 were 0.700, 0.680 and 0.778 in PTB group respectively. Conclusion Serum CXCR3 ligands may be helpful in the diagnosis of active pulmonary tuberculosis, especially CXCL11 and CXCL9 are more prominent than CXCL10.

Key words: Tuberculosis, pulmonary, Chemokines, CXCR3 Receptors, Enzyme-linked immunosorbent assay, Diagnosis, differential