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中国防痨杂志 ›› 2021, Vol. 43 ›› Issue (5): 513-515.doi: 10.3969/j.issn.1000-6621.2021.05.018

• 短篇论著 • 上一篇    下一篇

CD44及相关细胞因子水平对活动性肺结核诊断及预后评估价值

陈科帆, 熊域皎, 焦家欢, 袁术生()   

  1. 614000 四川省乐山市人民医院感染科
  • 收稿日期:2020-12-22 出版日期:2021-05-10 发布日期:2021-04-30
  • 通信作者: 袁术生 E-mail:chenkefan1986217LY@163.com
  • 基金资助:
    2019年度四川省高校人文社会科学重点研究基地科研项目(SWFZ19-Y-37)

Value of CD44 and related cytokine levels in the diagnosis and prognosis evaluation of active pulmonary tuberculosis

CHEN Ke-fan, XIONG Yu-jiao, JIAO Jia-huan, YUAN Shu-sheng()   

  1. Department of Infectious Diseases, People’s Hospital of Leshan, Sichuan Province, Leshan 614000, China
  • Received:2020-12-22 Online:2021-05-10 Published:2021-04-30
  • Contact: YUAN Shu-sheng E-mail:chenkefan1986217LY@163.com

摘要:

为探讨CD44及上下游相关细胞因子与活动性肺结核病变发展及预后的关系,笔者采用回顾性研究的方法,搜集乐山市人民医院感染科2018年1月至2019年7月治疗的86例活动性肺结核患者作为观察组,选取本院同期40名健康体检者作为对照组。应用酶联免疫吸附试验检测CD44、γ-干扰素(IFN-γ)和肿瘤坏死因子α(TNF-α)表达水平。结果显示,观察组治疗前和治疗6个月后CD44、TNF-α和IFN-γ表达水平[治疗前分别为(54.37±8.26)μmol/L、(42.72±6.12)μmol/L、(35.83±5.14)μmol/L;治疗6个月后分别为(20.14±3.25)μmol/L、(11.38±1.52)μmol/L、(16.42±2.57)μmol/L]均明显高于对照组[分别为(12.16±1.42)μmol/L、(5.38±1.06)μmol/L、(7.52±1.22)μmol/L],差异均有统计学意义(t值分别为21.147、26.528、20.712、8.106、9.132、11.614,P值均为0.000)。观察组治疗6个月后CD44、TNF-α和IFN-γ表达水平均明显低于治疗前,差异均有统计学意义(t值分别为10.713、18.552、16.124,P值均为0.000)。应用受试者工作特征曲线分析CD44表达水平预测活动性肺结核的价值,曲线下面积为0.84(95%CI:0.77~0.91),截断值为26.74μmol/L,诊断敏感度为90.3%,特异度为86.4%。由此可见,检测外周血CD44表达水平可能对活动性肺结核有诊断和评估预后的价值。

关键词: 结核,肺, 抗原, CD44, 诊断, 预后, 评价研究

Abstract:

In order to explore the relationship between CD44 and upstream and downstream related cytokines and the development and prognosis of active pulmonary tuberculosis (PTB), a retrospective study was conducted. Eighty-six PTB patients from the Department of Infectious Diseases, Leshan People’s Hospital between January 2018 and July 2019 were collected as the observation group, and the control group included 40 healthy subjects having physical examination in the same period. Enzyme-linked immunosorbent assay was used to detect the expression levels of CD44, interferon-γ (IFN-γ) and tumor necrosis factor α (TNF-α). The results showed that the expression levels of CD44, TNF-α and IFN-γ in the observation group before treatment and 6 months after treatment (before treatment: (54.37±8.26) μmol/L, (42.72±6.12) μmol/L and (35.83±5.14) μmol/L, respectively; after 6 months of treatment: (20.14±3.25) μmol/L, (11.38±1.52) μmol/L and (16.42±2.57) μmol/L, respectively) were all significantly higher than those in the control group ((12.16±1.42) μmol/L, (5.38±1.06) μmol/L and (7.52±1.22) μmol/L, respectively) (t values were 21.147, 26.528, 20.712, 8.106, 9.132, 11.614, respectively; all P=0.000). In the observation group, the expression levels of CD44, TNF-α and IFN-γ 6 months after treatment were significantly lower than those before treatment (t values were 10.713, 18.552, 16.124, all P=0.000). The value of CD44 expression level in predicting PTB was analyzed using receiver operating characteristic curve. The area under the curve was 0.84 (95%CI: 0.77-0.91), the cut-off value was 26.74 μmol/L, and the sensitivity was 90.3%, he specificity was 86.4%, which indicated that detecting the expression level of CD44 in peripheral blood may have diagnostic and prognostic value for PTB.

Key words: Tuberculosis, pulmonary, Antigens, CD44, Diagnosis, Prognosis, Evaluation studies