Characteristics of CT images of pulmonary tuberculosis complicated by fungal infection and levels of miR-29a-3p,miR-223-3p,IFN-γ,IL-23R
OBJECTIVE To analyze the characteristics of computed tomography(CT)images of pulmonary tubercu-losis complicated with fungal infection and the levels of micrornas 29a-3p(miR-29a-3p),miR-223-3p,interferon-γ(IFN-γ)and interleukin-23 receptor(IL 23R).METHODS Totally 104 cases of pulmonary tuberculosis compli-cated with fungal infection treated in Songzi People's Hospital from Jun.2019 to Jun.2023 were included(the study group),and 115 cases of pulmonary tuberculosis patients without fungal infection were included in the con-trol group.The fungal types of pulmonary tuberculosis complicated by fungal infection were analyzed,and the CT image characteristics,clinical manifestations,expression levels of miR-29a-3p,miR-223-3p,IFN-γ and IL-23R were compared between the two groups.Receiver operating characteristic(ROC)curve was drawn to analyze the predictive value of miR-29a-3p,miR-223-3p,IFN-γ and IL-23R expression levels for the poor prognosis of pa-tients with pulmonary tuberculosis complicated with fungal infection.RESULTS A total of 121 strains of fungi were detected in 104 cases of pulmonary tuberculosis complicated by fungal infection,mainly Candida alba and Cryptococcus.The proportion of cavities,crescent signs and nodules,halo signs,segmental lobed solid shadow,tree bud signs,hemoptysis and moist rales were higher in the study group(P＜0.05).The serum levels of miR-29a-3p,miR-223-3p,IFN-γ,and IL-23R in the study group were 1.46±0.41,0.78±0.21,(72.02±13.19)ng/ml,and(29.08±5.27)ng/ml,respectively,higher than those in the control group(P＜0.05);The serum levels of miR-29a-3p,miR-223-3p,IFN-γ,and IL-23R in the poor prognosis group were 1.77±0.31,0.98±0.26,(76.04±7.43)ng/ml,and(33.02±4.39)ng/ml,respectively,higher than those in the good prognosis group(P＜0.05).Poor prognosis was included in positive,good prognosis was included in negative,ROC curve was plotted to ana-lyze the predictive value of serum miR-29a-3p,miR-223-3p,IFN-γ and IL-23R expression levels on the prognosis of patients with pulmonary tuberculosis complicated with fungal infection,and the area under the curve(AUC)was 0.830,0.834,0.740,0.789,0.867,and the combined detection was superior to the single detection(P＜0.05).CONCLUSION The clinical features and CT imaging characteristics of pulmonary tuberculosis complicated with fungal infection were obvious,with the occurrence of pulmonary tuberculosis complicated with fungal infec-tion and the deterioration of prognosis,the expression levels of serum miR-29a-3p,miR-223-3p,IFN-γ and IL-23R increased,and the combined detection had high predictive value for the prognosis of patients.
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