IFN-γ、MMP-9水平在肺结核中的表达及与其病情活动性的相关性

Expression of IFN⁃γand MMP⁃9 in pulmonary tuberculosis and its correlation with disease activity

目的 分析血清干扰素-γ(IFN-γ)、基质金属蛋白酶-9(MMP-9)水平在肺结核患者中的表达及与其病情活动性的相关性。方法 选取2019年1至2022年12月新乡医学院第一附属医院收治的264例疑似肺结核患者作为研究对象,经确诊后分为结核组(n=204例)及非结核组(n=60例),根据病情活动情况将结核组分为活动性肺结核组(n=86例)及非活动性肺结核组(n=118例),另选取同期于本院进行健康体检者80名为健康组。比较结核组、非结核组、健康组与结核组中活动性肺结核组、非活动性肺结核组及活动性肺结核中轻症组、重症组间血清IFN-γ、MMP-9水平;分析IFN-γ、MMP-9单一及联合检测肺结核的诊断效能;采用多元Logistic回归分析影响活动性肺结核患者病情程度的相关性因素。结果 三组血清IFN-γ、MMP-9水平比较:结核组>非结核组>健康组,差异具有统计学意义(P<0.05);活动性肺结核患者血清IFN-γ、MMP-9水平均显著高于非活动性肺结核,差异有统计学意义(P<0.05);86例活动性肺结核患者中轻症54例,重症32例。重症患者病程比轻症患者长,吸烟比例及血清IFN-γ、MMP-9水平均显著高于轻症患者,差异有统计学意义(P<0.05);IFN-γ、MMP-9联合诊断肺结核的灵敏度、特异度、准确度分别为93.55%、61.54%、84.09%,均高于三者单独检测(P<0.05);经Logistic回归分析,吸烟、血清IFN-γ及MMP-9均为影响活动性肺结核患者病情程度的相关因素(P<0.05)。结论 肺结核患者血清IFN-γ及MMP-9水平显著升高,二者联合对肺结核具有较好的诊断效能,且为影响活动性肺结核病情严重程度的重要影响因素,对肺结核病情评估具有重要价值。

Objective To analyze serum interferon-γ(Interferon gamma,IFN-γ),the expression of matrix metalloproteinase-9(MMP-9)levels in pulmonary tuberculosis and its association with disease activ-ity.Methods 264 suspected pulmonary tuberculosis patients admitted to the First Affiliated Hospital of Xinx-iang Medical College from January 2019 to December 2022 were selected as the subjects of the study.After diag-nosis,they were divided into a tuberculosis group(n=204 cases)and a non-tuberculosis group(n=60 cases).The tuberculosis group was further categorized based on disease activity into an active pulmonary tuberculosis group(n=86 cases)and a non-active pulmonary tuberculosis group(n=118 cases).In addition,80 healthy indi-viduals who underwent physical examinations in our hospital during the same period were selected as the control group.The serum levels of IFN-γand MMP-9 were compared between the active pulmonary tuberculosis group,the non-active pulmonary tuberculosis group,and the mild and severe active tuberculosis subgroups within the active tuberculosis group.The diagnostic efficacy of IFN-γand MMP-9,both individually and in combination,for detecting pulmonary tuberculosis was analyzed.The serum levels of IFN-γand MMP-9 in pa-tients with mild and severe cases of active pulmonary tuberculosis were compared,and the correlation factors affecting the severity of active pulmonary tuberculosis patients were analyzed by multivariate logistic regres-sion.Results The comparison of serum IFN-γand MMP-9 levels among three groups showed that the tuber-culosis group>non tuberculosis group>healthy group,and the differences among the three groups were statis-tically significant(P<0.05).The sensitivity,specificity,and accuracy of combined diagnosis using MMP-9 were 93.55%,61.54%,and 84.09%,respectively,which were higher than those detected separately by the three methods(P<0.05).Among 204 pulmonary tuberculosis patients,86 were active pulmonary tuberculosis patients,and 118 were non-active pulmonary tuberculosis patients.The average levels of serum IFNγand MMP-9 in active pulmonary tuberculosis patients were significantly higher than in non-active pulmonary tuber-culosis patients,with a statistically significant difference(P<0.05).In the evaluation of the condition,54 cases were mild and 32 cases were severe among the 86 patients with active pulmonary tuberculosis.Severe pa-tients with active pulmonary tuberculosis had a longer course of mild disease,higher smoking rates,and sig-nificantly higher levels of serum IFN-γand MMP-9 comparedc to mild patients,with a statistically significant difference(P<0.05).According to logistic regression analysis,smoking,serum IFN-γand MMP-9 are re-lated factors affecting the severity of active pulmonary tuberculosis patients(P<0.05).Conclusion Serum levels of IFN-γand MMP-9 in patients with pulmonary tuberculosis are significantly increased,and the combi-nation of the two has good diagnostic efficacy for pulmonary tuberculosis.It is an important influencing factor affecting the severity of active pulmonary tuberculosis,and has important value for the assessment of pulmo-nary tuberculosis.