Expression and clinical significance of peripheral blood MIP-1α and sCD163 in patients with active pulmonary tuberculosis
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摘要: 目的 探讨外周血巨噬细胞炎症蛋白1-α(MIP-1α)、可溶性分化簇163(sCD163)在活动性肺结核(APTB)患者中的表达水平及临床意义。方法 选取2020年4月—2024年1月中国人民解放军联勤保障部队第九八〇医院感染科收治的APTB患者265例(APTB组)和潜伏性结核感染(LTBI)患者135例(LTBI组),另选取同期来院健康体检志愿者135例(对照组)。APTB患者根据病情程度分为轻度APTB组(94例)、中度APTB组(120例)、重度APTB组(51例),根据预后分为不良预后组(74例)和良好预后组(191例)。收集临床资料,采用酶联免疫吸附法检测外周血MIP-1α和sCD163水平。通过多因素非条件logistic回归分析外周血MIP-1α和sCD163水平与APTB患者预后的关系,采用受试者操作特征(ROC)曲线分析外周血MIP-1α和sCD163水平对APTB的预测效能。结果 APTB组外周血MIP-1α和sCD163水平高于LTBI组和对照组,差异有统计学意义(P＜0.05)。重度APTB组外周血MIP-1α和sCD163水平高于中度和轻度APTB组,差异有统计学意义(P＜0.05)。APTB患者的不良预后发生率为27.92%(74/265),与良好预后组比较,不良预后组外周血MIP-1α和sCD163水平升高,差异有统计学意义(P＜0.05)。调整混杂因素后,高MIP-1α、高sCD163为APTB患者不良预后的独立危险因素(P＜0.05)。外周血MIP-1α和sCD163联合预测APTB患者不良预后的曲线下面积(AUC)为0.883,大于外周血MIP-1α和sCD163单独预测的AUC(分别为0.790和0.792)(P＜0.05)。结论 APTB患者外周血MIP-1α和sCD163水平升高,与病情严重程度和不良预后有关,外周血MIP-1α和sCD163联合预测APTB患者不良预后的效能较高。
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关键词:
- 活动性肺结核 /
- 巨噬细胞炎症蛋白1-α /
- 可溶性分化簇163 /
- 病情 /
- 预后
Abstract: Objective To investigate the expression and clinical significance of macrophage inflammatory protein-1α (MIP-1α) and soluble cluster of differentiation 163 (sCD163) in the peripheral blood of patients with active pulmonary tuberculosis (APTB). Methods A total of 265 APTB patients (an APTB group) and 135 latent tuberculosis infection (LTBI) patients (a LTBI group) who were admitted to Department of Infectious Diseases, the 980th Hospital of the Joint Logistics Support Force of the Chinese People's Liberation Army, from April 2020 to January 2024 were enrolled. Meanwhile, another 135 healthy volunteers undergoing routine medical examinations in the same hospital were set as a control group. According to disease severity, APTB patients were further divided into a mild APTB group (n=94), a moderate APTB group (n=120), and a severe APTB group (n=51). Based on prognosis, the patients were further divided into a good prognosis group (n=191) and a poor prognosis group (n=74). Their clinical data were collected and peripheral blood MIP-1α and sCD163 levels were measured by enzyme-linked immunosorbent assay. The relationship between peripheral blood MIP-1α and sCD163 levels and APTB prognosis was analyzed by multivariate unconditional logistic regression. The prediction efficiency of MIP-1α and sCD163 levels for APTB prognosis was assessed by receiver operating characteristic (ROC) curve analysis. Results The levels of peripheral blood MIP-1α and sCD163 in the APTB group were significantly higher than those in the LTBI group and the control gromp (P<0.05). Patients in the severe APTB group showed increased peripheral blood MIP-1α and sCD163 levels compared with those in the moderate and mild APTB groups (P<0.05). The incidence of poor prognosis was 27.92% (74/265). The levels of MIP-1α and sCD163 in the poor prognosis group were significantly higher than those in the good prognosis group (P<0.05). After adjusting for confounding factors, high MIP-1α and high sCD163 levels were identified as independent risk factors for poor prognosis in APTB patients (P<0.05). The area under the ROC curve (AUC) for combined prediction of poor prognosis using MIP-1α and sCD163 was 0.883, which was significantly higher than the AUCs for MIP-1α (0.790) and sCD163 (0.792) alone (P<0.05). Conclusions Elevated levels of MIP-1α and sCD163 in the peripheral blood of APTB patients are associated with disease severity and poor prognosis. Combined detection of peripheral blood MIP-1α and sCD163 provides high predictive efficiency for poor prognosis in APTB patients. -
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