干扰素γ、白细胞介素-32及涎液化糖链抗原6水平检测在肺结核治疗转归中的评估作用

Evaluation effect of detection of interferon γ,interleukin-32 and krebs von den lungen 6 levels in the treatment outcome of pulmonary tuberculosis

目的 研究干扰素γ(IFN-γ)、白细胞介素-32(IL-32)及涎液化糖链抗原6(KL-6)水平检测在肺结核治疗转归中的评估作用。方法 纳入肺结核患者84例(研究组)及同期体检且结果正常的健康者70例(对照组)。再根据治疗转归将研究组患者分为治疗有效组(51例)及治疗无效组(33例)。比较各组受试者IFN-γ、IL-32及KL-6水平,比较治疗有效组与治疗无效组患者病灶部位空洞情况。采用多元logistic回归分析评估影响肺结核患者治疗转归的独立危险因素。采用受试者工作特征(ROC)曲线分析IFN-γ、IL-32及KL-6对肺结核治疗转归的评估作用。结果研究组受试者IFN-γ水平低于对照组,IL-32、KL-6水平均高于对照组;治疗无效组患者IFN-γ水平低于治疗有效组,IL-32、KL-6水平及病灶部位空洞比例均高于治疗有效组(P<0.05)。多元logistic回归分析结果显示,年龄≥65岁、病灶部位空洞、IFN-γ水平降低、IL-32及KL-6水平升高均是影响肺结核患者治疗转归的独立危险因素(P<0.05)。ROC曲线分析结果显示,IFN-γ、IL-32、KL-6三者联合检测肺结核治疗转归的ROC曲线下面积(AUC)最大(P>0.05)。结论 IFN-γ、IL-32、KL-6三者联合检测能够有效评估肺结核治疗转归,临床上值得推广使用。

Objective To investigate the evaluation effect of detection of interferon γ(IFN-γ),interleukin-32(IL-32) and krebs von den lungen 6(KL-6) levels in the treatment outcome of pulmonary tuberculosis.Methods A total of 84 patients with pulmonary tuberculosis(study group) and 70 healthy subjects(control group) with normal results during physical examination in the same period were included.According to the treatment outcome, 84 patients in the study group were divided into treatment effective group(51 cases) and treatment ineffective group(33 cases).IFN-γ,IL-32 and KL-6 levels were compared among all groups, and the cavity at the lesion site was compared between treatment effective group and treatment ineffective group.Multiple logistic regression was used to evaluate the independent risk factors affecting the treatment outcome of pulmonary tuberculosis patients.The evaluation effect of IFN-γ,IL-32 and KL-6 on the treatment outcome of pulmonary tuberculosis were analyzed by receiver operation characteristic(ROC) curve.Results IFN-γ level in study group was lower than that in control group, while IL-32 and KL-6 levels were higher than those in control group;IFN-γ level in treatment ineffective group was lower than that in treatment effective group, IL-32 and KL-6 levels and the percentage of cavity at the lesion site were higher than those in treatment effective group(P<0.05).Multiple logistic regression analysis showed that Age≥65 years old, cavity at the lesion site, decreased IFN-γ level, increased IL-32 and KL-6 levels were all independent risk factors affecting the treatment outcome of patients with pulmonary tuberculosis(P<0.05).ROC curve results showed that the combined detection of pulmonary tuberculosis treatment outcome of IFN-γ,IL-32 and KL-6 had the largest area under ROC curve(AUC)(P>0.05).Conclusion The combined detection of IFN-γ,IL-32 and KL-6 can effectively evaluate the treatment outcome of pulmonary tuberculosis, which is worth to use in clinic practice.