IL-1Ra/IL-1β比值联合血清学方法在布鲁氏菌病感染鉴别中的应用

Value of IL-1Ra/IL-1βcombined with serological methods in differentiation of Brucellosis infection

目的分析血清白细胞介素-1受体拮抗因子(IL-1Ra)/白细胞介素-1β(IL-1β)比值联合虎红平板凝集试验(RBPT)或试管凝集试验(SAT)在布鲁氏菌病感染鉴别中的应用价值。方法采集郑州市疾病预防控制中心门诊部布鲁氏菌病高危职业人群静脉血样本195份,进行RBPT试验和SAT试验,并以病原体分离试验及抗人球蛋白试验等综合检测结果为金标准,比较RBPT试验和SAT试验检测布鲁氏菌病的效能;检测血清中IL-1Ra/IL-1β比值水平,利用受试者工作特征曲线(ROC)分析血清IL-1Ra/IL-1β比值联合RBPT或SAT试验诊断布鲁氏菌病感染的效能。结果195例血清样本中综合检测阳性率为18.97%(37/195),RBPT试验检测阳性31例,敏感度为78.37%,特异度为98.73%,SAT试验检测的阳性27例,敏感度为70.27%,特异度为99.37%;阳性组血清中IL-1Ra水平及IL-1Ra/IL-1β比值均低于阴性组(P<0.05),IL-1β水平高于阴性组(P<0.05);ROC结果显示:IL-1Ra/IL-1β比值、联合RBPT试验、联合SAT试验诊断布鲁氏菌病感染的AUC分别为0.875、0.951、0.953,95%CI为0.795~0.955、0.898~1.000、0.898~1.000,敏感度分别为78.40%、91.90%、91.90%,特异度分别为95.60%、94.90%、98.10%;IL-1Ra/IL-1β比值联合RBPT试验或SAT试验的AUC均高于IL-1Ra/IL-1β比值单独检测的AUC(P<0.05)。结论布鲁氏菌病感染阳性血清中IL-1Ra/IL-1β比值显著降低,利用血清IL-1Ra/IL-1β比值联合RBPT试验或SAT试验能够提高布鲁氏菌病感染的诊断效能。

OBJECTIVE To analyze the value of serum interleukin-1 receptor antagonist(IL-1 Ra)/interleukin-1β(IL-1β)combined with rose bengal plate agglutination test(RBPT)or serum agglutination test(SAT)in differentiation of Brucellosis infection.METHODS A total of 195 venous blood samples were collected from population at high risk of Brucellosis in outpatient department of Disease Control and Prevention Center in Zhengzhou,RBPT and SAT were performed,the results of comprehensive tests such as pathogen separation test and anti-human globulin test were taken as the golden standards,the sensitivity and specificity of RBPT and SAT for detecting Brucellosis were compared.The serum IL-1 Ra/IL-1βwas detected,and the efficiency of serum IL-1 Ra/IL-1βcombined with RBPT or SAT in diagnosis of Brucellosis infection was analyzed by means of receiver operating characteristic(ROC)curves.RESULTS Among the 195 serum samples,the positive rate of comprehensive tests was 18.97%(37/195).RBPT showed there were 31 positive cases,the sensitivity and specificity were 78.37%and 98.73%,respectively.SAT showed there were 27 positive cases,the sensitivity and specificity were 70.27%and 99.37%,respectively.The level of serum IL-1 Ra and IL-1 Ra/IL-1βof the positive group were lower than those of the negative group(P<0.05),while the IL-1βlevel of the positive group was higher than that of the negative group(P<0.05).The result of ROC curve analysis showed that the AUCs of IL-1 Ra/IL-1β,IL-1 Ra/IL-1βcombined with RBPT and IL-1 Ra/IL-1βcombined with SAT were respectively 0.875,0.951 and 0.953 in diagnosis of Brucellosis infection,95%CI were respectively 0.795~0.955,0.898~1.000 and 0.898~1.000,the sensitivities were respectively 78.40%,91.90%and 91.90%,and the specificities were respectively 95.60%,94.90%and 98.10%.The AUC of the IL-1 Ra/IL-1βcombined with RBPT or SAT was significantly higher than that of the single detection of IL-1 Ra/IL-1β(P<0.05).CONCLUSION The serum IL-1 Ra/IL-1βof the patients with Brucellosis infection is remarkably reduced,and the serum IL-1 Ra/IL-1βcombined with RBPT or SAT may raise the diagnostic efficiency of Brucellosis infection.