胸腔积液红细胞沉降率、转化生长因子-β1及白细胞介素-27对结核性胸膜炎预后的评估

Evaluation of ESR,TGF-β1 and IL-27 in pleural effusion for the prognosis of tuberculous pleurisy

目的探讨分析胸腔积液红细胞沉降率(erythrocyte sedimentation rate,ERS)、转化生长因子-β1(transforming growth factor-β1,TGF-β1)、白细胞介素-27(interleukin-27,IL-27)对结核性胸膜炎预后的评估价值。方法选择2021年3月至2023年3月无锡五院收治的184例结核性胸膜炎患者,根据患者治疗预后情况将患者分为预后良好组(n=146)和预后不良组(n=38)。收集并记录2组患者临床资料,比较2组患者胸腔积液ESR、TGF-β1、IL-27水平,对可能影响患者临床预后的各因素进行单因素及多因素Logistic回归分析,采用受试者工作特征曲线(receiver operating characteristic,ROC)曲线分析患者胸腔积液ESR、TGF-β1、IL-27水平对不良预后预测价值。结果2组患者在性别、糖尿病、高血压以及冠心病方面比较,差异均无统计学意义(P均>0.05),而2组患者在年龄、就诊时间、胸腔积液细胞数、胸腔积液蛋白总量方面比较,差异均具有统计学意义(P均<0.05)。预后不良组患者胸腔积液ESR、TGF-β1、IL-27水平均显著高于预后良好组(P均<0.05)。多因素Logistic回归分析结果显示,胸腔积液ESR、TGF-β1、IL-27以及胸腔积液细胞数、胸腔积液蛋白总量进入回归模型(P<0.05)。采用ROC曲线分析患者胸腔积液ESR、TGF-β1、IL-27水平对不良预后的预测价值,曲线下面积分别为0.787、0.852、0.892(P<0.05)。结论结核性胸膜炎患者胸腔积液ESR、TGF-β1、IL-27可在一定程度上预测患者预后,从而为患者病情评估以及治疗效果的评估提供一定的参考价值,值得临床进一步深入研究分析。

Objective To evaluate the prognostic value of pleural effusion ESR,TGF-β1 and IL-27 in tuberculous pleurisy.Methods One hundred and eighty-four patients with tuberculous pleurisy admitted to our hospital from March 2021 to March 2023 were selected and divided into good prognosis group(n=146)and poor prognosis group(n=38)according to the prognosis of the patients.Clinical data of the 2 groups of patients were collected,and the levels of ESR,TGF-β1 and IL-27 in pleural effusion of the 2 groups were measured and compared.Univariate and multivariate Logistic regression analysis was performed for various factors that may affect the clinical prognosis of the patients.ROC curve was used to analyze the predictive value of ESR,TGF-β1 and IL-27 in patients with pleural effusion.Results There were no statistically significant differences between the 2 groups in gender,diabetes,hypertension and coronary heart disease(P>0.05),but there were statistically significant differences in age,duration time of treatment,number of pleural fluid cells and total pleural fluid protein between the 2 groups(P<0.05).The levels of ESR,TGF-β1 and IL-27 in pleural effusion in poor prognosis group were significantly higher than those in good prognosis group(P<0.05).Multivariate Logistic regression analysis showed that ESR,TGF-β1,IL-27,the number of pleural effusion cells and total pleural effusion protein entered the regression model(P<0.05).ROC curve was used to analyze the predictive value of ESR,TGF-β1 and IL-27 in patients with pleural effusion,and the areas under the curve were 0.787,0.852 and 0.892,respectively(P<0.05).Conclusion ESR,TGF-β1,and IL-27 in pleural effusion of patients with tuberculous pleurisy can predict the prognosis of patients to a certain extent,thus providing certain reference value for the evaluation of patients’condition and treatment effect,which is worthy of further clinical research and analysis.