| 吴多池,云 飞,吴烨莹,周丹霞,余 杏.CD64指数、血清sTREM-1、IFN-γ水平与肺结核患者药物敏感试验结果的关系及对MDR-PTB患者治疗后痰菌阴转的影响[J].,2023,(9):1781-1786 |
| CD64指数、血清sTREM-1、IFN-γ水平与肺结核患者药物敏感试验结果的关系及对MDR-PTB患者治疗后痰菌阴转的影响 |
| Relationship between CD64 Index, Serum sTREM-1, Serum IFN-γ Levels and Drug Susceptibility Test Results in Patients with Pulmonary Tuberculosis and Their Effect on Sputum Bacteria Negative Conversion in Patients with Multidrug-Resistant Pulmonary Tuberculosis after Treatment |
| 投稿时间：2022-09-02 修订日期：2022-09-27 |
| DOI：10.13241/j.cnki.pmb.2023.09.035 |
| 中文关键词: 肺结核 CD64指数 sTREM-1、IFN-γ MDR-PTB 痰菌阴转 影响因素 |
| 英文关键词: Pulmonary Tuberculosis CD64 index sTREM-1 IFN-γ MDR-PTB Sputum bacteria negative conversion Influencing factors |
| 基金项目:海南省自然科学基金项目（822RC866） |
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| 中文摘要: |
| 摘要 目的：探讨CD64指数、血清可溶性髓系细胞触发受体-1（sTREM-1）、干扰素-γ（INF-γ）水平与肺结核患者药物敏感试验结果的关系及耐多药肺结核（MDR-PTB）患者治疗后痰菌阴转的影响因素。方法：选取我院2018年4月至2020年12月收治的408例肺结核患者作为研究对象，根据实验室药物敏感试验结果将其分为耐多药组113例、多耐药组60例、耐单药组110例、非耐药组125例，检测四组研究对象的CD64指数、血清sTREM-1、INF-γ水平；根据耐多药组患者治疗6个月后痰菌是否阴转分为阴转组和非阴转组，并观察MDR-PTB患者治疗前后的CD64指数、血清sTREM-1、INF-γ水平的变化，并分析影响MDR-PTB患者治疗后痰菌阴转的影响因素。结果：耐多药组、多耐药组患者的CD64指数、血清sTREM-1水平显著高于耐单药组、非耐药组（P<0.05）；耐多药组、多耐药组患者的血清INF-γ水平低于耐单药组、非耐药组（P<0.05）。治疗6个月后，MDR-PTB阴转组患者的CD64指数、血清sTREM-1水平显著低于非阴转组，血清INF-γ水平显著高于非阴转组，差异均具有统计学意义（P<0.05）。多因素Logistic回归分析结果显示：病灶范围≥3个肺野、肺结核空洞、耐药种数≥3种、CD64指数（较高）、sTREM-1（较高）是MDR-PTB患者痰菌阴转的危险因素（P<0.05），血清INF-γ（较高）是MDR-PTB患者痰菌阴转的保护因素（P<0.05）。结论：CD64指数、血清sTREM-1、INF-γ与肺结核患者药物敏感试验结果具有一定的关系，治疗后CD64指数、血清sTREM-1升高是MDR-PTB患者痰菌阴转的危险因素，而INF-γ升高是MDR-PTB患者痰菌阴转的保护因素。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the relationship between CD64 index, serum soluble myeloid trigger receptor-1 (sTREM-1), interferon-γ (INF-γ) levels and drug susceptibility test results in patients with pulmonary tuberculosis and influencing factors of sputum bacteria negative conversion in patients with multidrug-resistant pulmonary tuberculosis (MDR-PTB) after treatment. Methods: A total of 408 patients with pulmonary tuberculosis who were admitted to our hospital from April 2018 to December 2020 were selected as the research subjects. According to the laboratory drug sensitivity test results, they were divided into the MDR-PTB group with 113 cases, multi-drug resistance group with 60 cases, single drug resistance group with 110 cases and non-drug resistance group with 125 cases. The CD64 index, serum sTREM-1 and INF-γ levels of the subjects in the four groups were detected. The patients of MDR-PTB group were divided into negative conversion group and non-negative conversion group according to whether the sputum turned negative at 6 months after treatment, and the changes of CD64 index, serum sTREM-1 and INF-γ levels in patients with MDR-PTB before and after treatment were observed, and the influencing factors of negative conversion of sputum bacteria after treatment in patients with MDR-PTB were analyzed. Results: The CD64 index and serum STREM-1 level in the MDR-PTB group and multi-drug resistance group were significantly higher than those in the single drug resistance group and non-drug resistance group (P<0.05). The serum INF-γ level in the the MDR-PTB group and multi-drug resistance group was lower than that in the single drug resistance group and non-drug resistance group (P<0.05). 6 months after treatment, the CD64 index and serum sTREM-1 level of patients in the MDR-PTB negative conversion group were significantly lower than those in the non-negative conversion group, and the serum INF-γ level was significantly higher than that in the non-negative conversion group, and the differences were statistically significant (P<0.05). Multivariate Logistic regression analysis showed that: the range of lesions≥3 lung fields, pulmonary tuberculosis cavity, number of drug-resistant species≥3, CD64 index (higher) and sTREM-1 (higher) were risk factors for sputum bacterial negative conversion in patients with MDR-PTB (P<0.05), and serum INF-γ (higher) was a protective factor for sputum bacterial negative conversion in patients with MDR-PTB (P<0.05). Conclusion: CD64 index, serum sTREM-1 and INF-γ have certain relationship with the results of drug sensitivity test in patients with pulmonary tuberculosis. The increase of CD64 index and serum sTREM-1 after treatment is the risk factor of sputum bacteria negative conversion in patients with MDR-PTB, while the increase of INF-γ is the protective factor of sputum bacteria negative conversion in patients with MDR-PTB. |
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