肺结核患者血清降钙素原与sTREM-1水平及其临床价值

Clinical significance of PCT and s TREM-1 in patients with pulmonary tuberculosis

目的探讨PCT和s TREM-1在肺结核患者血清中水平及临床意义。方法随机选取87例结核患者,另纳入健康志愿者60例。采用免疫荧光法检测血清PCT,酶联免疫吸附试验(ELISA)检测血清s TREM-1。结果肺结核组血清PCT、CRP和s TREM-1的水平均高于健康人组(PPCT<0.01,PCRP=0.037,Ps TREM-1<0.01),重症肺结核患者血清PCT、CRP和s TREM-1的水平均高于轻症肺结核组(PPCT<0.01,PCRP=0.041,Ps TREM-1=0.039);PCT对重症肺结核的诊断曲线下面积为0.738(P<0.01),当PCT的诊断阈值为0.22ng/ml时,其诊断的敏感性为69%,特异性为74%,s TREM-1的诊断曲线下面积为0.715(P<0.01),当s TREM-1的诊断阈值为15.82 ng/m L时,其诊断的敏感性为66%,特异性为79%;两者联合诊断的ROC曲线下面积为0.840(P<0.01)。结论血清PCT和s TREM-1在肺结核患者中均有所升高,联合PCT和s TREM对肺结核的诊断具有一定的指示作用。

Objective To investigate the clinical significance of serum PCT and sTREM-1 in pulmonary tu-berculosis patients. Methods 87 patients with pulmonary tuberculosis were selected as the study group, and 60 healthy cases as the control group. The level of serum PCT was detected by immunofluorescence method, and the lev-el of serum sTREM-1 was detected by ELISA. Results The levels of PCT, CRP and sTREM-1 were significantly higher in pulmonary tuberculosis than in healthy controls and they were significantly higher in the severe group than in the mild group. Receiver operating characteristic （ROC） curves were used to evaluate the diagnosis value of PCT, CRP and sTREM-1 in severe pulmonary tuberculosis. The area under AUC curve of PCT and sTREM-1 were 0. 738 and 0. 715 respectively. The combined diagnosis value of AUC was 0. 840. The cut-off of PCT was 0. 22ng/ mL, and the sensitivity and specificity were 69% and 74% respectively. The cut-off of sTREM-1 was 15. 82ng/ mL, and the sensitivity and specificity were 66% and 79% respectively. Conclusion The serum concentration of PCT and sTREM-1 increases in pulmonary tuberculosis patients. The combination of PCT and sTREM-1 can improve sensitivity and specificity obviously in the diagnosis of pulmonary tuberculosis.