A study on the value of serum eotaxin and human β-defensin-1 in the differential diagnosis of active pulmonary tuberculosis and their relationship with clinical efficacy
Objective To explore the value of serum eotaxin(Eot)and human β-defensin-1(hBD-1)in the differential diagnosis of active pulmonary tuberculosis(ATB),and to analyze the relationship between them and clinical efficacy.Methods A total of 162 ATB patients admitted to Panzhihua Central Hospital from March 2020 to October 2022 were selected(ATB group),and 81 healthy individuals undergoing physical examination(healthy group)and 81 patients with latent tuberculosis infection(LTBI group)were selected during the same period.Serum Eot and hBD-1 levels were detected and compared among the three groups.Receiver operating characteristic(ROC)curve was used to analyze their differential diagnostic value for LTBI and ATB.All the patients in the ATB group were treated with 2HRZE/4HR reg-imen,and these patients were divided into effective group and ineffective group according to their clinical efficacy,and the serum Eot and hBD-1 levels were compared between the two groups.The risk factors affecting the efficacy of the ATB patients were analyzed using multivariate logistic regression analysis.The predictive value of serum Eot and hBD-1 for efficacy were analyzed using ROC curve.Results The levels of serum Eot in the ATB group and the LTBI group were higher than those in the healthy group,and the levels of serum hBD-1 in the ATB group and the LTBI group were lower than those in the healthy group,and the differences were significant(P＜0.05).The levels of serum Eot in the ATB group were higher than those in the LTBI group,and the levels of serum hBD-1 in the ATB group were lower than those in the LTBI group,and the differences were significant(P＜0.05).The results of ROC curve analysis showed that the levels of serum Eot and hBD-1 had the differential diagnostic value for LTBI and ATB(P＜0.05),and the combi-nation of the two indicators had better differential diagnostic efficacy[AUC(95％CI)=0.834(0.696-0.969),P＜0.001],with sensitivity and specificity being 83.33％and 82.72％,respectively.In the 162 patients with ATB,the effective rate was 76.54％(124/162)and the ineffective rate was 23.46％(38/162).Smoking history,tuberculosis complicated with tuberculous cavity and the levels of Eot in the ineffective group were significantly higher than those in the effective group(P＜0.05),and the levels of hBD-1 in the ineffective group were significantly lower than those in the effective group(P＜0.05).The results of multivariate logistic regression analysis showed that smoking history,tuberculosis com-plicated with tuberculous cavity,higher level of Eot and lower level of hBD-1 were independent risk factors for inef-fective treatment of ATB(P＜0.05).The results of ROC curve analysis showed that both serum Eot and hBD-1 levels could effectively predict the efficacy of the ATB patients(P＜0.05),and the combined predictive efficacy of the two indicators was better[AUC(95％CI)=0.842(0.720-0.940),P＜0.001],with sensitivity and specificity being 81.58％and 82.26％,respectively.Conclusion Increased serum Eot levels and decreased hBD-1 levels in ATB patients are helpful to distinguish LTBI from ATB,and higher Eot levels and lower hBD-1 levels are independent risk factors for inef-fective treatment in the ATB patients.The combined detection of serum Eot and hBD-1 has a higher reference value in predicting the efficacy of the ATB patients.
Active pulmonary tuberculosisEotaxinHuman β-defensin-1DiagnosisEfficacy
维普
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