细胞因子联合检测在结核病辅助诊断中的应用价值

Auxiliary diagnostic value of combined cytokinesin Tuberculosis

目的运用液相芯片检测研究对象血清中12种细胞因子IL-1β,IL-2,IL-4,IL-5,IL-6,IL-8,IL-10,IL-12p70,IL-17,IFN-γ,IFN-α,TNF-α表达差异,探讨液相芯片技术用于活动性肺结核病诊断的应用价值。方法选择3组人群为研究对象,包括37例活动性结核病患者,33例潜伏感染者和33例健康对照,运用液相芯片技术检测3组人群中12种细胞因子表达水平,统计各细胞因子用于肺结核诊断的灵敏度和特异度,最后进一步用统计学方法分析多个细胞因子联合检测的诊断价值。结果活动性结核病组中的IFN-γ,IL-8,IL-6,TNF-α,IL-1β水平均高于结核潜伏感染组,差异有统计学意义(P<0.05);活动性结核病组中的IFN-γ,IL-8,IL-6,TNF-α的表达水平高于健康对照组,差异有统计学意义(P<0.05),IL-4,IL-5水平低于健康人群组,差异有统计学意义(P<0.05)。经ROC曲线,发现联合三个细胞因子IFN-γ,IL-8,IL-6诊断活动性结核病的AUC值为0.905;敏感度为75.70%,特异度为95.50%。结论血清IFN-γ,IL-8,IL-6联合检测可以有效的区分活动性结核患者与潜伏感染者,健康人群,细胞因子IFN-γ,IL-8,IL-6联合检测可以作为活动性结核病患者早期诊断的指标。

Objective The expression differences of 12 cytokines(IL-1β,IL-2,IL-4,IL-5,IL-6,IL-8,IL-10,IL-12p70,IL-17,IFN-γ,IFN-α)in serum of the subjects were detected by Suspension bead array in orderto explore the application value of Suspension bead array technology in the diagnosis of active pulmonary tuberculosis.Methods All caseswere divided into three groups including 33 healthy control group,33 cases whohad latent tuberculosis infection,and 37 caseswithtuberculosis.The expressionLevels of 12 kinds of cytokines in 3 groups were detected by suspension bead array.ROC analysis was used to test thesensitivity and specificityofeach cytokine and the combination of the cytokines on the diagnosis of Tuberculosis.Results The levels of IFN-γ,IL-8,IL-6,TNF-α,IL-1βof the tuberculosis group were higher than those of the latent tuberculosis infection group,and difference between the two groups had statistical significance(P<0.05).The IFN-γ,IL-8,IL-6,TNF-αlevels in the tuberculosis group were higher than those in the healthy control group,andthe difference was statistically significant(P<0.05),IL-4,IL-5 levels were lower than those in the healthy control group,with statistically significant differences(P<0.05).According to ROC curves,AUC value of the combined three cytokines IFN-γ,IL-8 and IL-6 in the diagnosis of active tuberculosis was found to be 0.905,the sensitivity was 75.70%and the specificity was 95.50%.Conclusion IFN-γtogether with IL-8 and IL-6 were demonstrated to be the potential cytokine complex for the assessment between pulmonary tuberculosis patients from latent cases and from healthy control cases.IF N-γtogether with IL-8 and IL-6 can be used as an indicator for the early diagnosis of active tuberculosis.