活动性肺结核患者血清降钙素原与视黄醇结合蛋白联合检测的临床意义

Clinical significance of combined detection of serum procalcitonin and retinol binding protein in active pulmonary tuberculosis patients

目的探讨活动性肺结核患者血清降钙素原(PCT)与视黄醇结合蛋白(RBP)联合检测的临床意义。方法选取2019年1月—2020年12月阜阳市第二人民医院收治的70例活动性肺结核患者(研究组)为研究对象,其中涂片阳性36例,涂片阴性34例;另选取同时间段收治的非活动性肺结核患者62例(非活动性肺结核组)、健康体检者68人(健康组)作为对照。比较健康组、非活动性肺结核及研究组血清PCT、RBP水平,比较涂片阳性与阴性患者血清PCT、RBP水平;分析血清PCT联合RBP检测对活动性肺结核的诊断价值。结果研究组血清PCT为(1.39±0.24)ng/ml,高于非活动性肺结核组与健康组(P<0.05);研究组血清RBP为(25.13±3.09)mg/L,明显低于非活动性肺结核组与健康组(P<0.05);非活动性肺结核组血清PCT水平高于健康组(P<0.05),且RBP水平低于健康组(P<0.05)。涂片阳性患者血清PCT为(1.51±0.23)ng/ml,明显高于涂片阴性患者(P<0.05);涂片阳性患者血清RBP为(23.57±3.98)mg/L,明显低于阴性患者(P<0.05)。ROC曲线分析显示血清PCT、RBP及二者联合诊断活动性肺结核的曲线下面积分别为0.797(95%CI:0.685~0.910)、0.730(95%CI:0.608~0.852)、0.881(95%CI:0.801~0.961)。结论活动性肺结核尤其是涂片阳性患者血清PCT水平均明显升高,RBP水平明显降低,血清PCT联合RBP检测对活动性肺结具有较高诊断价值。

Objective To investigate the clinical significance of combined detection of procalcitonin(PCT) and retinol binding protein(RBP) in patients with active pulmonary tuberculosis. Methods Seventy patients with active pulmonary tuberculosis(active group,smear positive 36 and negative 34 cases) who were admitted to Fuyang Second People’s Hospital from January 2019 to December 2020,62 patients with inactive pulmonary tuberculosis(inactive group) admitted during the same period,and 68 healthy participants who underwent physical examination(healthy group). Serum PCT and RBP levels were compared between the active group,inactive group,and healthy group as well as between smear-positive and negative patients. The diagnostic value of combined measurement of PCT and RBP for active pulmonary tuberculosis was analyzed. Results The active group showed a significantly higher serum PCT level(1.39±0.24)ng/ml and a significantly lower serum RBP level(25.13±3.09)mg/L(P<0.05) compared with the inactive group and healthy group. The inactive group had a significantly higher serum PCT level and a significantly lower serum RBP level than the healthy group(P<0.05). The serum PCT level was(1.51±0.23) ng/ml in the smear-positive patients,which was significantly higher than that in the smear-negative patients(P<0.05). The serum RBP level was(23.57±3.98)mg/L in the smear-positive patients,which was significantly lower than that in the smear-negative patients(P<0.05). The receiver operating characteristic curve analysis showed that the area under the curve was 0.797(95%CI:0.685-0.910) for PCT,0.730(95%CI:0.608-0.852) for RBP,and 0.881(95%CI:0.801-0.961)for combined detection of PCT and RBP. Conclusion The patients with active pulmonary tuberculosis,especially smear-positive patients,had a significantly increased serum PCT level and a significantly decreased serum RBP level.Combined detection of PCT and RBP showed high diagnostic value for active pulmonary tuberculosis.