Diagnostic value of peripheral blood IFN-γ,PCT and OPN levels on active pulmonary tuberculosis and their correlation with the prognosis of anti-tuberculosis treatment
Objective To explore the diagnostic value of peripheral blood interferon-γ(IFN-γ),procalcitonin(PCT)and osteopontin(OPN)levels on active pulmonary tuberculosis and their correlation with the prognosis of anti-tuberculosis treatment.Methods 210 patients with active pulmonary tuberculosis were selected as the active pulmonary tuberculosis group,and 60 healthy subjects during the same period were selected as the healthy control group.The levels of IFN-γ,PCT and OPN in peripheral blood were compared between the two groups.Patients with active pulmonary tuberculosis were given 2HRZE/4HR regimen for anti-tuberculosis treatment.Patients were divided into cured group(161 cases)and uncured group(49 cases)according to whether they were cured or not.Serum IFN-γ,PCT and OPN levels were compared between the active pulmonary tuberculosis group before treatment and the healthy control group.Binary Logistic regression analysis and combined diagnostic model of active pulmonary tuberculosis were constructed based on IFN-γ,PCT and OPN,and the predictive efficacy of single and combined diagnostic models of IFN-γ,PCT and OPN were analyzed.Serum levels of IFN-γ,PCT and OPN before and after treatment were compared between cured group and untreated group.The correlation between serum IFN-γ,PCT and OPN levels before treatment and the prognosis of treatment was analyzed in patients with active pulmonary tuberculosis.Results Serum IFN-γ,PCT and OPN levels of active pulmonary tuberculosis group were(23.20±10.01)pg/ml,(1.46±0.60)ng/ml and(721.79±303.62)ng/ml before treatment,which were significantly higher than(5.69±2.74)pg/ml,(0.25±0.11)ng/ml and(171.99±68.53)ng/ml of healthy control group,and the difference was statistically significant(P<0.05).Binary Logistic regression analysis was performed with serum IFN-γ,PCT and OPN levels of the study subjects as independent variables and the presence of active tuberculosis as dependent variable.The results showed that elevated levels of serum IFN-γ[OR=2.000,95%CI=(1.215,3.294)],PCT[OR=1.023,95%CI=(1.005,1.042)],and OPN[OR=1.049,95%CI=(1.008,1.092)]were the independent risk factors for active pulmonary tuberculosis(P<0.05).The final model equation was P=1/[1+e(-19.197+0.693×IFN-γ+0.0230×PCT+0.048×OPN].Receiver operating characteristic(ROC)curve analysis showed that the area under the curve(AUC)of IFN-γ,PCT and OPN for predicting active pulmonary tuberculosis were 0.797,0.637 and 0.756,respectively,at which time the sensitivity and specificity of IFN-γ were 62.9%and 93.3%,those of OPN were 53.3%and 91.7%,those of PCT were 51.0%and 85.0%.The binary Logistic regression model combining the above indicators predicted an AUC of 0.892 for active pulmonary tuberculosis,with a sensitivity of 76.2%and a specificity of 98.3%,and the overall diagnostic performance of the model was better than that of individual indicators.In intra-group comparison,serum levels of IFN-γ,PCT and OPN decreased in patients of the cured and uncured groups after 6 months of treatment compared with before treatment,and the difference was statistically significant(P<0.05).Comparing between groups,the differences in serum IFN-γ,PCT and OPN levels between the cured and uncured groups before treatment were not statistically significant(P>0.05).After 6 months of treatment,the serum levels of IFN-γ,PCT and OPN in the cured group were significantly lower than those in the uncured group,and the difference was statistically significant(P<0.05).Pearson correlation analysis showed that the pre-treatment serum IFN-γ,PCT and OPN levels of patients with active pulmonary tuberculosis were negatively correlated with anti-tuberculosis cure(P<0.05).Conclusion Elevated levels of peripheral IFN-γ,PCT and OPN are not only closely associated with the development of active pulmonary tuberculosis,but also may be potential biomarkers for the assessment of the efficacy and prognosis of anti-tuberculosis treatment in patients.
Active pulmonary tuberculosisInterferon-γProcalcitoninOsteopontinDiagnostic valuePrognosis
万方数据
维普
