肺结核患者血清趋化因子CXCL8、RANTES与疗效的相关性

Correlation between serum chemokines CXCL8,RANTES and curative effect in pulmonary tuberculosis patients

目的探究肺结核(pulmonary tuberculosis,PTB)患者血清CXC趋化因子配体8(C-X-C motif chemokine ligand 8,CXCL8)、调节活化正常T细胞表达和分泌因子(regulate upon activation normal T cell expressed and secreted,RANTES)水平与治疗效果的关系。方法选取2020年2月至2021年2月温州医科大学附属衢州医院收治的450例初诊涂阳的PTB患者为研究对象。所有患者均采用标准抗PTB治疗,根据治疗效果分为有效组(n=383)和无效组(n=67)。比较两组一般资料及血清CXCL8、RANTES水平,采用Logistic回归分析PTB患者治疗效果的影响因素以及CXCL8、RANTES对PTB患者治疗效果的预测价值。结果治疗后,450例PTB患者治疗有效率为85.11%。无效组的全程督导占比低于有效组,吸烟、外地户籍占比及治疗前血清CXCL8、RANTES水平高于有效组,差异均有统计学意义(P<0.05),性别、职业、年龄比较,差异无统计学意义(P>0.05)。多因素Logistic回归分析结果显示,吸烟、户籍类型、CXCL8及管理方式是PTB患者治疗无效的影响因素(P<0.05)。血清CXCL8、RANTES预测PTB患者治疗效果的曲线下面积(areas under the curve,AUC)分别为0.877、0.865,敏感度分别为77.6%、79.1%,特异性分别为88.3%、89.3%;CXCL8、RANTES联合预测PTB患者治疗效果的AUC为0.955,敏感度为94.0%,特异性为85.4%。结论血清CXCL8、RANTES高水平与PTB患者治疗不良密切相关,检测血清CXCL8、RANTES有利于评估PTB患者治疗效果,且二者联合预测效果更佳。

Objective To investigate the relationship between serum C-X-C motif chemokine ligand 8(CXCL8),regulate upon activation normal T cell expressed and secreted(RANTES)levels and the therapeutic effect in patients with pulmonary tuberculosis(PTB).Methods A total of 450 patients with PTB who were newly diagnosed with smear-positive in Quzhou Hospital Affiliated to Wenzhou Medical University from February 2020 to February 2021 were gathered as the research objects,all of whom were treated with standard anti-PTB treatment,and the treatment effects of all PTB patients were recorded,and they were separated into effective group(n=383)and ineffective group(n=67)according to the treatment effect.The general data and serum CXCL8 and RANTES levels of the two groups were compared.Logistic regression was used to analyze the factors affecting the treatment outcome of PTB patients and the predictive value of CXCL8 and RANTES on the treatment outcome of PTB patients.Results After treatment,the effective rate of 450 patients with PTB was 85.11%.The proportion of total supervision in the ineffective group was lower than that in the effective group,and the proportion of smoking,non-resident residence and serum CXCL8 and RANTES before treatment were higher than those in the effective group,the differences were statistically significant(P<0.05),while the differences in gender,occupation and age were not statistically significant(P>0.05).Multiple Logistic regression analysis showed that smoking,household registration type,CXCL8 and management style were the influencing factors of treatment ineffectiveness in patients with PTB(P<0.05).The areas under the curve(AUC)of serum CXCL8 and RANTES were 0.877 and 0.865,the sensitivity were 77.6%and 79.1%,and the specificity was 88.3%and 89.3%,respectively.AUC of CXCL8 and RANTES combined to predict the therapeutic effect of PTB patients was 0.955,the sensitivity was 94.0%,and the specificity was 85.4%.Conclusion The high levels of serum CXCL8 and RANTES are closely related to the poor treatment of PTB patients.The detection of serum CXCL8 and RANTES is helpful to evaluate the treatment effect of PTB patients,and the combined prediction effect of the two is better.