Serum IAP and 25(OH)D Levels and Predictive Value of Therapeutic Effect in Patients with First Retreatment of Positive Pulmonary Tuberculosis Complicated with Diabetes
Objective To investigate expression changes of serum immunosuppressive acidic protein (IAP)and 25-hydroxyvitamin D [25 (OH)D]in patients with bacteria positive TB combined with DM after the first retreatment and to evaluate their predictive values for treatment efficacy.Methods From January,2019 to April,2022,48 patients with bacterial-positive TB combined with DM who were initially re-treated in our hospital were gathered as the experimental group,while another 48 patients with simple TB were enrolled as the control group.Serum IAP and 25 (OH)D levels of patients in these two groups before and after treatment were measured and compared;Multivariate logistic regression was applied to identify the potential factors affecting sputum bacteria negative conversion in patients with bacteria-positive TB combined with DM;Receiver operating characteristic (ROC)curve was drawn to evaluate the predictive value of IAP and 25 (OH)D for no sputum bacteria negative conversion.Results 31 cases (64.58％)of the patients with sputum bacteria negative conversion in the experimental group were significantly lower than the 40 cases (83.33％)in the control group.After 2 months of treatment,serum IAP in the experimental group and the control group was significantly decreased,while the 25(OH)D level was significantly increased (P<0.05);After 2 months of treatment,the serum IAP level in the experimental group was significantly lower than that in the control group,while the 25 (OH)D level was significantly higher than that in the control group (P<0.05 ).Multivariate logistic regression analysis showed that high IAP level was a risk factor for no sputum bacteria negative conversion in patients with sputum bacteria positive TB combined with DM after the first retreatment (P<0.05),and high level of 25 (OH)D was the risk factor for no sputum bacteria negative conversion in patients with sputum bacteria positive TB combined with DM after the first retreatment (P<0.05).ROC curve showed that the AUC of IAP for predicting no sputum bacteria negative conversion was 0.719,while the AUC of 25 (OH)D for predicting no sputum bacteria negative conversion was 0.791,and the AUC of combination of the two for predicting no sputum conversion was 0.871,which was significantly higher than that of individual markers (Zcombination vs IAP=2.605,P=0.009;Zcombination vs 25(OH)D=2.408,P=0.016),and the sensitivity and specificity were 78.46％ and 82.86％,respectively.Conclusion The serum IAP level decreases and the 25(OH)D level increases after the first re-treatment for patients with bacteria-positive TB combined with DM.The combination of these two markers has a certain predictive value for the no sputum bacteria negative conversion in patients with bacteria-positive TB combined with DM.
Retreated bacterial-positive pulmonary tuberculosisDiabetesImmunosuppressive acidic protein25-Hydroxyvitamin DEfficacyPredictive value
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维普
