肺结核患者血清SAMD9L基因表达水平与病情严重程度及预后的关系

The relationship between serum SAMD9L expression with disease severity and prognosis in pulmonary tuberculosis patients

目的探究无菌α基序域9样蛋白(sterile alpha motif domain containing 9-like,SAMD9L)基因在肺结核患者血清中的表达水平与患者病情严重程度及预后的关系。方法选取2019年2月20日─2020年6月23日期间我院收治的232例肺结核患者作为研究对象,根据患者病情严重程度分为轻症组(129例)和中重症组(103例),收集并分析2组患者的一般资料。采用实时荧光定量PCR法检测血清中SAMD9L基因表达水平,比较2组间差异。采用ROC曲线分析血清SAMD9L mRNA表达水平对肺结核患者病情严重程度及预后的评估价值。结果中重症组血清SAMD9L mRNA表达水平显著高于轻症组(P<0.05);中重症组预后不良的患者中有吸烟史人数及血清SAMD9L mRNA表达水平显著高于预后良好的患者(P<0.05)。血清SAMD9L mRNA评估肺结核患者病情严重程度的AUC为0.783(95%CI:0.724~0.834),敏感度和特异性度分别为68.93%和77.52%,最优截断值为1.22;血清SAMD9L mRNA评估肺结核患者预后不良的AUC为0.691(95%CI:0.627~0.750),敏感度和特异度分别为64.00%和66.88%,最优截断值为1.25。结论肺结核患者血清SAMD9L mRNA表达水平与病情严重程度及预后密切相关,病情越严重,血清SAMD9L mRNA表达水平越高,可为肺结核的早期诊断提供参考依据。

Objective To explore the relationship between serum mRNA expression of sterile alpha motif domain containing 9-like(SAMD9L)with disease severity and prognosis in pulmonary tuberculosis patients.Methods We enrolled 232 pulmonary tuberculosis patients admitted to our hospital from February 20,2019 to June 23,2020 as study subjects.According to the severity of the disease,the patients were grouped into mild group(129 cases),moderate to severe group(103 cases).Baseline data of the 2 groups of patients were collected and analyzed.Real-time fluorescent quantitative PCR was used to detect the level of SAMD9L expression in serum,and compare the differences of 2 groups.The ROC curve was drawn to analyze and evaluate the value of serum SAMD9L mRNA expression level for disease severity and prognosis in pulmonary tuberculosis patients.Results The serum SAMD9L mRNA expression in the moderate to severe group was higher than that in the mild group(P<0.05);the number of patients with smoking history and the expression of serum SAMD9L mRNA in the patients with poor prognosis in the moderate to severe group were significantly higher than those in the patients with favorable prognosis(P<0.05).The AUC of serum SAMD9L mRNA to assess the disease severity in pulmonary tuberculosis patients was 0.783(95%CI:0.724~0.834),the sensitivity and specificity were 68.93%and 77.52%,respectively,and the optimal cut-off value was 1.22;the AUC of serum SAMD9L mRNA to assess the poor prognosis in pulmonary tuberculosis patients was 0.691(95%CI:0.627~0.750),the sensitivity and specificity were 64.00%and 66.88%,respectively,and the optimal cut-off value was 1.25.Conclusions The level of SAMD9L mRNA expression in pulmonary tuberculosis patients is closely related to severity and prognosis of the disease.The more serious the disease is,the higher the serum SAMD9L mRNA expression level is,which can provide reference for the early diagnosis of pulmonary tuberculosis.