睾酮、雌二醇在男性肺结核合并炎症性贫血患者中的表达意义

Expression of testosterone and estradiol in male patients with pulmonary tuberculosis combined with anemia of inflammation

目的探讨睾酮(testosterone,T)、雌二醇(estradiol,E2)在肺结核(TB)合并炎症性贫血(AI)患者中的表达及其与疾病的相关性。方法选择2018年1月至2019年9月于我院确诊的TB患者39例和TB合并AI患者34例作为研究对象,获取患者基线资料,年龄、身高、身体质量指数(BMI)、吸烟史、饮酒史、高血压病史、糖尿病病史、实验室指标,红细胞计数(RBC)、血红蛋白(Hb)、网织红细胞计数(RET)、激素水平,睾酮(T)、雌二醇(E2),构建体外刺激实验确定E2、T与免疫机制关系;采用Spearman相关系数分析T、E2与实验室指标相关性;利用独立因子所建立的Logistic回归模型对所有样本进行诊断测试,分析并发AI的影响因素。结果TB组和TB合并AI组患者身高、BMI、吸烟史、饮酒史、高血压病史、糖尿病病史比较无显著差异(P>0.05),年龄、RBC、Hb、RET、E2、T比较有显著差异(P<0.05)。E2与T呈显著正相关关系(P<0.05);E2、T与RBC、Hb、RET均呈显著正相关关系(P<0.05)。RBC、Hb、E2、T为保护因素(P<0.05),年龄、RET是TB并发AI独立影响因素(P<0.05)。加入T、E2刺激的实验组CD3+、CD8+下降趋势较空白组有显著差异(P<0.05)。结论高表达T、E2可提高TB患者免疫机制和红细胞活化功能,对降低AI发生率有较高价值。

Objective To investigate the expression levels of testosterone(T)and estradiol(E2)in the male patients with pulmonary tuberculosis(TB)complicated with anemia of inflammation(AI)and to analyze their correlation with the disease.Methods A total of 39 TB patients combined with no AI and 34 TB patients combined with AI confirmed in our hospital from January 2018 to September 2019 were enrolled in this study.The baseline data[age,height,body mass index(BMI),smoking history,drinking history,hypertension history,and diabetes history],laboratory indicators[red blood cell(RBC),hemoglobin(Hb),and reticulocyte count(RET)],and hormone levels(T and E2)were collected.The relationship between E2 and T and the immune mechanism was determined by in vitro stimulation.Spearman correlation coefficient was used to analyze the correlation between T and E2 and the laboratory indexes.Logistic regression model established by independent factors was used to analyze the influencing factors of AI.Results There was no significant difference in height,BMI,smoking history,drinking history,hypertension history or diabetes history between TB group and TB combined with AI group(P>0.05).There were significant differences in age,RBC,Hb,RET,E2 and T between the two groups(P<0.05).E2 was significantly positively correlated with T(P<0.05),E2 and T were significantly positively correlated with RBC,Hb and RET(P<0.05).RBC,Hb,E2,and T were the protective factors(P<0.05),and RET was the independent influencing factor of TB combined with AI(P<0.05).The decrease of CD3+and CD8+in the TB combined with AI group with T and E2 stimulation was significantly different from that in TB group(P<0.05).Conclusion High expression of T and E2 can improve the immune mechanism and the activation function of the red cells of TB patients,which is of great value in reducing the incidence of AI.