首页|血清应激诱导蛋白2和胎球蛋白A水平与重症肺结核患者疾病转归的关系

血清应激诱导蛋白2和胎球蛋白A水平与重症肺结核患者疾病转归的关系

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目的 探讨血清应激诱导蛋白2(Sestrin2)、胎球蛋白A(Fetuin-A)与重症肺结核患者疾病转归的关系。方法 选取2020年12月-2022年12月收治的108例重症肺结核患者为研究对象。采用酶联免疫吸附法检测血清Sestrin2、Fetuin-A水平。根据30 d疾病转归情况将患者分为死亡组22例和生存组86例。采用受试者工作特征(ROC)曲线及曲线下面积(AUC)分析血清Sestrin2、Fetuin-A水平对重症肺结核患者死亡的预测价值,采用多因素Logistic回归分析探讨重症肺结核患者预后的影响因素。结果 生存组血清Fetuin-A水平高于死亡组,血清Sestrin2水平低于死亡组,差异有统计学意义(P<0。05)。血清Sestrin2、Fetuin-A 预测重症肺结核疾病转归的 AUC(95%CI)分别为 0。752(0。712~0。797)、0。887(0。842~0。937),截断值分别为12。39 ng/mL、350。67 μg/mL,特异度分别为55。64%、65。57%,灵敏度分别为92。73%、92。73%。两者联合诊断的AUC为0。920(0。875~0。970),特异度为86。06%,灵敏度为88。21%。死亡组糖尿病史占比高于生存组,呼气流量峰值(PEF)、最大呼气中段流量(MMEF)、第1秒用力呼气容积(FEV1)水平、左心室射血分数(LVEF)低于生存组,差异有统计学意义(P<0。05)。多因素 Logistic 回归分析显示,LVEF≤50。00%(OR=3。777,95%CI:1。393~10。243)、Fetuin-A<350。67 μg/mL(OR=3。031,95%CI:1。943~4。730)、Sestrin2≥12。39 ng/L(OR=5。709,95%CI:1。933~16。355)是重症肺结核疾病转归的危险因素(P<0。05)。结论 血清Sestrin2、Fetuin-A水平变化与重症肺结核患者疾病转归密切相关,可作为评估重症肺结核疾病转归的生物学指标,且两者联合检测的准确率更高。
Relationships of serum Sestrin2 and Fetuin-A levels with disease outcome in patients with severe pulmonary tuberculosis
Objective To explore the relationships of serum Sestrin2 and Fetuin-A with disease outcome in patients with severe pulmonary tuberculosis.Methods A total of 108 patients with severe pulmonary tuberculosis admitted to our hospital from December 2020 to December 2022 were selected as study objects.Serum Sestrin2 and Fetuin-A levels were determined by enzyme-linked immunosor-bent assay.According to 30 d disease outcomes,the patients in the study group were divided into death-disease group(22 cases)and survival group(86 cases).Receiver operating characteristic(ROC)curve and area under the curve(AUC)were used to analyze the predictive value of serum Ses-trin2 and Fetuin-A levels in patients with severe pulmonary tuberculosis.The influencing factors of prog-nosis in patients with severe pulmonary tuberculosis were explored by multivariate Logistic regression.Results The serum Fetuin-A level in the survival group was higher than that in the death group,and the serum Sestrin2 level was lower than that in the death group(P<0.05).The AUC(95%CI)of ser-um Sestrin2 and Fetuin-A were 0.752(0.712 to 0.797)and 0.887(0.842 to 0.937),respectively,with truncation values of 12.39 ng/mL and 350.67 μg/mL,the specificity of 55.64%and 65.57%,and the sensitivity of 92.73%and 92.73%.The AUC of the combined diagnosis was 0.920(0.875 to 0.970),the specificity was 86.06%,and the sensitivity was 88.21%.The proportion of diabetes history in the death group was higher than that in the survival group,and peak expiratory flow(PEF),maximum mid-expiratory flow(MMEF),forced expiratory volume in the first second(FEV1)and left ventricu-lar ejection fraction(LVEF)were lower than those in the survival group(P<0.05).Multiple Logistic regression analysis showed that LVEF ≤50.00%(OR=3.777,95%CI,1.393 to 10.243),Fe-tuin-A<350.67 μg/mL(OR=3.031,95%CI,1.943 to4.730),Sestrin2≥12.39 ng/L(OR=5.709,95%CI,1.933 to 16.355)were the risk factors of the outcome of severe pulmonary tuber-culosis(P<0.05).Conclusion Serum Sestrin2 and Fetuin-A levels are closely related to the out-come of patients with severe pulmonary tuberculosis,and can be used as biological indicators to eval-uate the outcome of severe pulmonary tuberculosis.The combined prediction has higher accuracy.

stress-inducing protein 2fetoglobulin Asevere pulmonary tuberculosisdis-ease outcomebiological indexlung function

王孔、吴勇

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海南省万宁市人民医院呼吸内科,海南万宁,571500

应激诱导蛋白2 胎球蛋白A 重症肺结核 疾病转归 生物学指标 肺功能

海南省卫生健康行业科研项目

21A200287

2024

实用临床医药杂志
扬州大学,中国高校科技期刊研究会

实用临床医药杂志

CSTPCD
影响因子:1.543
ISSN:1672-2353
年,卷(期):2024.28(6)
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