肺结核患者血清甲壳质酶蛋白40、β-防御素-2水平及其对肺结核的诊断价值

Serum YKL-40 and HBD-2 levels in patients with pulmonary tuberculosis and their diagnostic value for pulmonary tuberculosis

目的探索肺结核患者血清甲壳质酶蛋白40(chitinase protein 40,YKL-40)、β-防御素-2(human beta defensin 2,HBD-2)水平及其对肺结核的诊断价值。方法选取2021年6月—2023年6月山东省立医院收治的86例肺结核患者为肺结核组,根据痰涂片结果分为活动性肺结核组(n=50)和非活动性肺结核组(n=36),另选取86例来自我院体检中心的健康受试者作为对照组。检测所有受试者血清中YKL-40、HBD-2水平并分析肺结核患者血清中YKL-40与HBD-2的相关性;采用受试者工作特征(receiver operating characteristic,ROC)曲线分析血清中YKL-40、HBD-2水平对肺结核及活动性肺结核的诊断价值。结果肺结核组血清YKL-40、HBD-2水平高于对照组(P均<0.05);活动性肺结核组血清YKL-40、HBD-2水平高于非活动性肺结核组(P均<0.05)。肺结核患者血清中YKL-40与HBD-2的水平呈正相关(r=0.601)。YKL-40、HBD-2及2者联合诊断肺结核的曲线下面积(area under the curve,AUC)分别为0.895、0.922、0.962,2者联合诊断优于单独诊断;YKL-40、HBD-2及2者联合诊断活动性肺结核的AUC分别为0.891、0.881、0.959,2者联合诊断优于单独诊断。结论肺结核患者血清YKL-40、HBD-2水平显著升高,且随病情加重而升高,2者对肺结核及活动性肺结核的具有一定的诊断价值。

Objective To explore the serum levels of chitinase protein 40(YKL-40)and human beta defensin 2(HBD-2)in patients with pulmonary tuberculosis and their diagnostic value.Methods From June 2021 to June 2023,86 confirmed pulmonary tuberculosis patients admitted in Shandong Provincial Hospital were included in the pulmonary tuberculosis group.They were separated into active pulmonary tuberculosis group(n=50)and non active pulmonary tuberculosis group(n=36)according to sputum smear results.An additional 86 healthy subjects from the same hospital’s physical examination center were selected as the control group.Detect and analyze the levels of YKL-40 and HBD-2 in the serum of all subjects.Analyze the correlation between YKL-40 and HBD-2 in the serum of patients with pulmonary tuberculosis.ROC curve was applied to analyze the diagnostic value of serum YKL-40 and HBD-2 levels for pulmonary tuberculosis and active pulmonary tuberculosis.Results Compared with the control group,the serum levels of YKL-40 and HBD-2 in the pulmonary tuberculosis group were significantly increased(P<0.05).Compared with inactive pulmonary tuberculosis group,the levels of serum YKL-40 and HBD-2 in active pulmonary tuberculosis group were significantly higher(P<0.05).The serum levels of YKL-40 and HBD-2 in patients with pulmonary tuberculosis were positively correlated(r=0.601).The area under the curve(AUC)of YKL-40,HBD-2,and their combination in the diagnosis of pulmonary tuberculosis was 0.895,0.922,and 0.962,respectively,the combination of the 2 was superior to single diagnosis.The AUC of YKL-40,HBD-2,and their combination in the diagnosis of active pulmonary tuberculosis was 0.891,0.881,and 0.959,respectively,the combination of the 2 was superior to single diagnosis.Conclusion The serum levels of YKL-40 and HBD-2 are obviously elevated in patients with pulmonary tuberculosis,which are positively correlated with the severity of disease,and their levels have certain diagnostic value for pulmonary tuberculosis and active pulmonary tuberculosis.