结核性胸膜炎胸腔积液中sTREM-1和PTX3表达及临床意义

Eexpression and Clinical Significance of sTREM-1 and PTX3 in Pleural Effusion of Tuberculous Pleurisy

目的:探究结核性胸膜炎(TBP)患者胸腔积液中可溶性髓样细胞触发受体-1(sTREM-1)和正五聚蛋白3(PTX3)表达水平,并分析其临床意义。方法:选择我院收治的98例TBP患者(TBP组),及同期一般资料与TBP组相匹配的84例非TBP患者为非TBP组;TBP组患者根据治疗效果分为预后良好组(70例),预后不良组(28例)。使用酶联免疫吸附法检测胸腔积液中sTREM-1和PTX3表达水平,并分析sTREM-1、PTX3在TBP组与非TBP组、预后良好组与预后不良组间差异;ROC曲线分析胸腔积液中sTREM-1和PTX3表达水平对TBP早期诊断及预后效果的评估。结果:TBP组患者胸腔积液中sTREM-1、PTX3表达水平显著高于非TBP组(t=13.516、12.036,P<0.05);ROC分析显示,sTREM-1联合PTX3诊断TBP的曲线下面积为0.962,大于单独sTREM-1、PTX3检测0.925和0.870(Z=2.910、4.233,P<0.05);预后不良组sTREM-1和PTX3表达水平高于预后良好组(t=10.051、11.729,P<0.05);sTREM-1联合PTX3诊断的曲线下面积为0.971大于单独sTREM-1、PTX3检测0.894和0.911(Z=1.969、2.356,P<0.05)。结论:TBP患者胸腔积液中sTREM-1和PTX3表达水平增加,预后不良患者患者胸腔积液sTREM-1和PTX3表达水平高于预后良好患者,sTREM-1联合PTX3可以用于鉴定TBP的发生,以及诊断预后效果。

Objective:To explore the expression levels of soluble triggering receptor expressed on myeloid cells-1(sTREM-1)and pentraxin 3(PTX3)in the pleural effusion of patients with tuberculous pleurisy(TBP),and analyze their clinical significance.Methods:Ninety-eight patients with TBP(TBP group)admitted in our hospital and 84 non-TBP patients whose general data matched with the TBP group during the same period were selected as the non-TBP group.The patients in the TBP group were divided into a good prognosis group(70 cases)and a poor prognosis group(28 cases)according to the treatment effect.Enzyme-linked immunosorbent assay was used to detect the expression levels of sTREM-1 and PTX3 in pleural effusion,and the differences in sTREM-1 and PTX3 were analyzed between TBP group and non-TBP group,between good prognosis group and poor prognosis group;ROC curve was used to analyze the effects of sTREM-1 and PTX3 expression in pleural effusion on the early diagnosis and prognosis of TBP.Results:The expression levels of sTREM-1 and PTX3 in pleural effusion in TBP group were significantly higher than those in non-TBP group(t=13.516,12.036,P<0.05);ROC analysis showed that the area under the curve of sTREM-1 combined with PTX3 in diagnosing TBP was 0.962,which was larger than 0.925 and 0.870 for sTREM-1 and PTX3 alone(Z=2.910,4.233,P<0.05);the expression levels of sTREM-1 and PTX3 in the poor prognosis group were higher than those in the good prognosis group(t=10.051,11.729,P<0.05);the area under the curve of sTREM-1 combined with PTX3 was 0.971,which was larger than 0.894 and 0.911 for sTREM-1 and PTX3 alone(Z=1.969,2.356,P<0.05).Conclusion:The expression levels of sTREM-1 and PTX3 in the pleural effusion of patients with TBP increased.The expression levels of sTREM-1 and PTX3 in the pleural effusion of patients with poor prognosis were higher than those of patients with good prognosis.sTREM-1 combined with PTX3 could be used to identify the occurrence of TBP and to diagnose the prognostic effect.