血清25（OH）D3、LL-37在活动性结核分枝杆菌感染患者中的表达及相关性

The Expressions and Correlation of Serum 25（OH）D3 and LL-37 in Patients with Active Mycobacterium Tuberculosis Infection

目的探讨血清25羟维生素D3[25(OH)D3]、人内源性抗菌肽(LL-37)在活动性结核分枝杆菌感染患者中的表达及相关性。方法选择2016年5月至2019年5月我院收治的活动性结核分枝杆菌感染患者72例作为病例组,同期在我院健康体检者50例作为对照组,检测并比较两组血清25(OH)D3、LL-37水平,检测并比较不同病情严重程度的活动性结核分枝杆菌感染患者血清25(OH)D3、LL-37水平,采用Pearson相关分析活动性结核分枝杆菌感染患者血清25(OH)D3、LL-37水平相关性,采用多因素Logistic回归分析活动性结核分枝杆菌感染的影响因素。结果病例组血清25(OH)D3水平明显低于对照组,差异具有统计学意义(P<0.05);病例组血清LL-37水平明显高于对照组,差异具有统计学意义(P<0.05);不同病情严重程度的活动性结核分枝杆菌感染患者血清25(OH)D3、LL-37水平差异具有统计学意义(P<0.05);血清25(OH)D3与LL-37呈负相关(P<0.05);活动性结核分枝杆菌感染患者血清25(OH)D3水平与痰涂片结果呈负相关(P<0.05);活动性结核分枝杆菌感染患者血清LL-37水平与痰涂片结果呈正相关(P<0.05);血清25(OH)D3、LL-37是活动性结核分枝杆菌感染的独立危险因素(P<0.05)。结论 25(OH)D3在活动性结核分枝杆菌感染患者血清中呈低表达,LL-37在活动性结核分枝杆菌感染患者血清中呈高表达,且与活动性结核分枝杆菌感染发生及严重程度相关,血清25(OH)D3、LL-37可能可作为活动性结核分枝杆菌感染的生物学标志物,检测活动性结核分枝杆菌感染患者血清25(OH)D3、LL-37水平可能有助于监测病情变化。

Objective To investigate the expressions and correlation of serum 25-hydroxyvitamin D3 [25(OH)D3] and endogenous antimicrobial peptide(LL-37)in patients with active Mycobacterium tuberculosis infection.Methods 72 patients with active Mycobacterium tuberculosis infection(the case group)and 50 cases of physical examinees(the control group)in our hospital from May,2016 to May,2019 were selected for the study.Serum levels of 25(OH)D3 and LL-37 were detected among all subjects and the levels were compared between two groups,as well as among patients with different severities.Pearson correlation analysis was used to analyze the correlation of serum 25(OH)D3 and LL-37 levels in patients with active Mycobacterium tuberculosis infection.Multivariate logistic regression was used to analyze the influencing factors of active Mycobacterium tuberculosis infection.Results The case group had lower serum 25(OH)D3 and higher LL-37 levels than those of the control group(P<0.05).Serum 25(OH)D3 and LL-37 levels showed significant difference among patients with different severity degrees(P<0.05).Serum 25(OH)D3 was negatively correlated with LL-37(P<0.05)and negatively correlated with sputum smear results in patients with active Mycobacterium tuberculosis infection(P<0.05),while serum LL-37 level was positively correlated with sputum smear results in patients with active Mycobacterium tuberculosis infection(P<0.05).Serum 25(OH)D3 and LL-37 were independent risk factors for active Mycobacterium tuberculosis infection(P<0.05).Conclusion Patients with active Mycobacterium tuberculosis infection have down-regulated 25(OH)D3 and up-regulated LL-37 levels,and the two factors are closely related to the occurrence and severity of active Mycobacterium tuberculosis infection,which can be used as indicators for the disease monitoring.