陈春光; 任鹏飞; 崔中锋

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DOI：

中文关键词: 外周血 Toll样受体2 IL-1β 活动性肺结核病情预后危险因素

英文关键词: peripheral blood Toll-like receptor 2 IL-1β active pulmonary tuberculosis patient’s condition prognosis risk factor

基金项目:

作者	单位
陈春光	郑州市第六人民医院医学检验科
任鹏飞	郑州市第六人民医院医学检验科
崔中锋	郑州市第六人民医院医学检验科

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中文摘要:

探讨外周血Toll样受体2（Toll like receptor 2, TLR2）mRNA、IL-1β在活动性肺结核患者病情及预后判定中的临床意义。方法　选取2019年1月—2020年12月我院收治的96例活动性肺结核患者作为病例组，同时选取我院80例健康体检者作为对照组。采用实时荧光定量PCR法检测外周血TLR2 mRNA表达水平，采用多重微球流式免疫荧光发光法检测血清IL-1β水平。比较2组外周血TLR2 mRNA、血清IL-1β水平差异，采用Spearman相关分析探讨TLR2 mRNA、IL-1β与APACHEⅡ评分的关系，采用ROC曲线分析外周血TLR2 mRNA、血清IL-1β对活动性肺结核患者预后的判定价值，采用多因素Logistic回归分析探讨活动性肺结核患者预后的相关因素。结果　病例组外周血TLR2 mRNA、血清IL-1β水平均显著高于对照组（P均＜0.05）。TLR2 mRNA、IL-1β与APACHEⅡ评分均呈正相关（r分别为0.532、0.592，P均＜0.05）。预后良好组（65例）外周血TLR2 mRNA、血清IL-1β水平显著低于预后不良组（31例）（P均＜0.05）。TLR2 mRNA、IL-1β在预测活动性肺结核患者预后的AUC分别为0.678（95%CI：0.566～0.781）、0.716（95%CI：0.669～0.783）。在5.76的临界值，TLR2 mRNA预测预后的灵敏度为84.4%，特异度为65.2%；在2.57的临界值，IL-1β预测预后的灵敏度为78.6%，特异度为60.1%。TLR2 mRNA与IL-1β联合检测的AUC为 0.911，灵敏度为87.1%，特异度为90.4%。多因素Logistic回归分析显示，TLR2 mRNA、IL-1β是活动性肺结核患者预后不良的危险因素（P均＜0.05）。结论　外周血TLR2 mRNA、血清IL-1β与活动性肺结核患者病情密切相关，且对患者预后具有一定的预测价值。

英文摘要:

To investigate the clinical significance of peripheral blood Toll like receptor 2 (TLR2) mRNA and interleukin 1β (IL-1β) in evaluating the condition and prognosis of patients with active pulmonary tuberculosis. Methods　A total of 96 active pulmonary tuberculosis patients admitted to our hospital from January 2019 to December 2020 were selected as the case group, and 80 healthy examinees in our hospital were simultaneously selected as the control group. Fluorescence real-time quantitative PCR was used to detect the expression level of TLR2 mRNA in peripheral blood, and multiplex microsphere flow immunofluorescence method was used to detect serum IL-1β level. The differences in peripheral blood TLR2 mRNA and serum IL-1β levels between 2 groups were compared. Spearman correlation analysis was used to explore the relationship between TLR2 mRNA, IL-1β and APACHE Ⅱ score. The ROC curve was used to analyze the value of peripheral blood TLR2 mRNA and serum IL-1β on the prognosis of patients with active pulmonary tuberculosis, and the related factors of the prognosis of patients with active pulmonary tuberculosis were analyzed by multivariate Logistic regression. Results　Compared with the control group, peripheral blood TLR2 mRNA and serum IL-1β levels of the case group were significantly higher (P＜0.05). TLR2 mRNA and IL-1β were positively correlated with APACHE Ⅱ score (r=0.532, 0.592, P＜0.05). The levels of peripheral blood TLR2 mRNA and serum IL-1β in the good prognosis group (65 cases) were significantly lower than those in the poor prognosis group (31 cases) (P＜0.05). The AUC of TLR2 mRNA and IL-1β on predicting the prognosis of patients with active pulmonary tuberculosis were 0.678 (95% CI: 0.566-0.781) and 0.716 (95% CI: 0.669-0.783), respectively. Under the cut-off value of 5.76, the sensitivity of TLR2 mRNA predicting prognosis was 84.4% and the specificity was 65.2%. Under the cut-off value of 2.57, the sensitivity of IL-1β predicting prognosis was 78.6% and the specificity was 60.1%. The AUC of TLR2 mRNA combined with IL-1β was 0.911, the sensitivity was 87.1%, and the specificity was 90.4%. The results of multivariate Logistic regression analysis showed that TLR2 mRNA and IL-1β were risk factors for the poor prognosis of patients with active pulmonary tuberculosis (P＜0.05). Conclusions　Peripheral blood TLR2 mRNA and serum IL-1β are closely related to the condition of patients with active pulmonary tuberculosis, and both have certain predictive value for the prognosis of patients.

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