首页|肺结核患者血清脂氧素A4在监测细菌载量和抗结核治疗进展中的价值

肺结核患者血清脂氧素A4在监测细菌载量和抗结核治疗进展中的价值

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目的 探究肺结核(pulmonary tuberculosis,PTB)患者血清脂氧素A4(lipoxin A4,LXA4)在监测细菌载量和抗结核治疗进展中的潜在价值.方法 选取2021年1月—2022年1月于陕西省结核病防治院就诊的40例活动性肺结核患者为活动性PTB组,38例潜伏性结核病感染者为LTBI组,另同期进行体检的28例健康志愿者为健康对照组.活动性PTB患者接受2个月标准抗结核化疗治疗,其余两组未做处理.在三组入组时(基线)、活动性PTB组治疗2个月和治疗完成6个月时抽取空腹静脉血,使用酶联免疫吸附试验(ELISA)测量血清LXA4水平,分析其与临床表现、细菌负荷、胸部影像学表现和治疗进展的关系.结果 入组时(基线),活动性PTB组、LTBI组和健康对照组血清LXA4水平分别为[397.72(210.68,573.0)]、[178.18(108.17,271.87)]和[131.06(76.24,166.04)]pg/mL,活动性PTB组明显高于LTBI组和健康对照组,差异有统计学意义(P<0.01).根据诊断时抗酸杆菌(AFB)痰涂片分级,活动性PTB组患者基线血清LXA4水平随萋尔-尼尔逊染色法(Ziehl-Neelson,Z-N)痰涂片等级升高而增加(P<0.001),且两者存在正相关性(rs= 0.209,P=0.003).治疗结束6个月后,活动性PTB组血清LXA4水平低于基线值(P=0.002).血清LXA4水平可预测治疗进展,基线灵敏度为55.0%(22/40),治疗完成6个月后,8例(20.0%)患者血清LXA4水平仍呈阳性.结论 血清LXA4可能是监测PTB治疗进展的有用生物标志物.
Value of serum LXA4 in monitoring bacterial load and progression of anti-tuberculosis treatment in patients with pulmonary tuberculosis
Objective To explore the potential value of serum lipoxin A4(LXA4)in monitoring bacterial load and anti-tuberculosis treatment progression in patients with pulmonary tuberculosis(PTB).Methods From January 2021 to January 2022,forty patients with active PTB,who were admitted to Shaanxi Provincial Tuberculosis Prevention and Control Hospital,were selected as the active PTB group,38 patients with latent tuberculosis infection(LTBI)were selected as the LTBI group,and 28 healthy volunteers who underwent physical examination in our hospital during the same period were included as the healthy control group.The active PTB patients received a 2-month standard anti-tuberculosis chemotherapy,while the other two groups were untreated.Fasting venous blood was drawn from the three groups at enrollment(baseline),after 2 months of treatment,and upon the completion of 6 months of treatment in the active PTB group to measure serum LXA4 levels using enzyme-linked immunosorbent assay(ELISA).The relationship between serum LXA4 level and clinical manifestations,bacterial load,chest imaging manifestations,and treatment progress was analyzed.Results At baseline,serum LXA4 levels in the active PTB group,LTBI group,and healthy control group were[397.72(210.68,573.00)],[178.18(108.17,271.87)],and[131.06(76.24,166.04)]pg/mL,respectively.The levels in the active PTB and LTBI groups were significantly higher than those in the healthy control group,with statistical significance(P<0.01).According to the grading of acid-fast bacilli(AFB)sputum smears at diagnosis,baseline serum LXA4 level increased in the active PTB group with AFB sputum smear grade(P<0.001),and there was a positive correlation between serum LXA4 level and sputum smear grade(rs=0.209,P=0.003).After 6 months of treatment,the serum LXA4 level in the active PTB group was lower than the baseline value(P=0.002).The serum LXA4 level can predict treatment progress,with a baseline sensitivity of 55.0%(22/40),and after 6 months of treatment,8 patients(20.0%)still showed positive serum LXA4 levels.Conclusions Serum LXA4 may be a useful biomarker for monitoring the progression of PTB treatment.

pulmonary tuberculosismonitoring bacterial loadbiomarkersLipoxin A4

王姗、高瑜、刘红艳、姬文兰、胡萍

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陕西省结核病防治院,陕西 西安 710100

肺结核 细菌载量 生物标志物 脂氧素A4

陕西省重点研发计划

2020SF-105

2024

中国热带医学
中华预防医学会,海南疾病预防控制中心

中国热带医学

CSTPCD北大核心
影响因子:0.722
ISSN:1009-9727
年,卷(期):2024.24(1)
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