摘要
目的探讨外周血可溶性白细胞介素2受体(sIL-2R)、CD4^(+)淋巴细胞百分比/CD8^(+)淋巴细胞百分比比值(下称CD4^(+)/CD8^(+))、肿瘤坏死因子-α(TNF-α)对初治活动性肺结核老年患者化疗疗效的评估价值。方法将2019年12月至2022年12月该院收治的102例初治活动性肺结核老年患者纳入研究作为观察组,另选取102例年龄≥60岁且同期于该院体检的健康者作为对照组。比较两组外周血sIL-2R、TNF-α、CD4^(+)/CD8^(+)水平并分析sIL-2R、TNF-α、CD4^(+)/CD8^(+)间的相关性。观察组均采用2HRZE/4HR抗结核治疗方案,比较观察组治疗前、治疗1个月、治疗6个月时不同疗效患者外周血sIL-2R、TNF-α、CD4^(+)/CD8^(+);分析sIL-2R、CD4^(+)/CD8^(+)、TNF-α水平与疗效的相关性;采用受试者工作特征(ROC)曲线分析各指标用于老年患者化疗疗效评估的效能。结果观察组sIL-2R、TNF-α水平高于对照组,而CD4^(+)/CD8^(+)低于对照组,差异均有统计学意义(P<0.05)。观察组sIL-2R、TNF-α与CD4^(+)/CD8^(+)呈负相关(P<0.05),sIL-2R与TNF-α呈正相关(P<0.05)。治疗1个月、治疗6个月时显效患者sIL-2R、TNF-α水平低于有效患者,而后者又低于无效患者,显效患者CD4^(+)/CD8^(+)高于有效患者,而后者又高于无效患者,差异均有统计学意义(P<0.05)。sIL-2R、TNF-α水平与疗效呈负相关(P<0.05),CD4^(+)/CD8^(+)与疗效呈正相关(P<0.05)。ROC曲线分析显示,治疗1个月、6个月时sIL-2R、CD4^(+)/CD8^(+)、TNF-α联合用于评估疗效的曲线下面积(AUC)明显大于各时间点单项指标用于评估的AUC(P<0.05),而且治疗6个月时各指标联合评估的AUC大于治疗1个月(P<0.05)。结论初治活动性肺结核老年患者sIL-2R、CD4^(+)/CD8^(+)、TNF-α水平与患者疗效密切相关,将以上指标联合用于评估患者化疗疗效具有一定参考价值。
Objective To investigate the value of peripheral blood soluble interleukin-2 receptor(sIL-2R),CD4^(+)lymphocyte percentage/CD8^(+)lymphocyte percentage ratio(hereinafter referred to as CD4^(+)/CD8^(+))and tumor necrosis factor-α(TNF-α)in evaluating the efficacy of chemotherapy in elderly patients with newly treated active pulmonary tuberculosis.Methods A total of 102 elderly patients with newly treated active tuberculosis admitted to the hospital from December 2019 to December 2022 were enrolled in the study as the observation group,and 102 healthy people aged 60 and older who underwent physical examination in the hospital during the same period were enrolled as the control group.The levels of sIL-2R,TNF-αand CD4^(+)/CD8^(+)in peripheral blood were compared between the two groups,and the correlations between sIL-2R,TNF-αand CD4^(+)/CD8^(+)were analyzed.The observation group was treated with 2HRZE/4HR anti-tuberculosis treatment regimen.The levels of sIL-2R,TNF-αand CD4^(+)/CD8^(+)in peripheral blood of patients with different efficacy before treatment,1 month and 6 months after treatment in the observation group were compared.The correlation between sIL-2R,CD4^(+)/CD8^(+),TNF-αlevels and therapeutic effect was analyzed.The receiver operating characteristic(ROC)curve was used to analyze the efficacy of indicators in evaluating the efficacy of chemotherapy in elderly patients.Results The levels of sIL-2R and TNF-αin the observation group were higher than those in the control group,while CD4^(+)/CD8^(+)was lower than that in the control group,and the differences were statistically significant(P<0.05).In the observation group,sIL-2R and TNF-αwere negatively correlated with CD4^(+)/CD8^(+)(P<0.05),sIL-2R was positively correlated with TNF-α(P<0.05).After 1 month and 6 months of treatment,the levels of sIL-2R and TNF-αin patients with apparent efficacy were lower than those in patients with efficacy,and the latter were lower than those in patients with no effect,while the CD4^(+)/CD8^(+)in patients with apparent efficacy was higher than that in patients with efficacy,and the latter was higher than that in patients with no efficacy,and the differences were statistically significant(P<0.05).The levels of sIL-2R and TNF-αwere negatively correlated with the efficacy(P<0.05),and CD4^(+)/CD8^(+)was positively correlated with the efficacy(P<0.05).ROC curve analysis showed that the area under the curve(AUC)of sIL-2R,CD4^(+)/CD8^(+),and TNF-αused in combination to assess efficacy was significantly greater than the AUCs of the single indicators used in the assessment at each time point of treatment(P<0.05),and the AUC of the combination of the indicators was greater after 6 months of treatment than after 1 month of treatment(P<0.05).Conclusion The levels of sIL-2R,CD4^(+)/CD8^(+)and TNF-αare closely related to the efficacy of chemotherapy in elderly patients with newly treated active pulmonary tuberculosis,and the combination of the above indicators has certain reference value in evaluating the efficacy of chemotherapy in patients.
作者
刘会
高江彦
霍琳
张晓光
张会晓
张焕
付洪义
王显雷
安贺娟
王勇
刘锐
陈素丽
李卫红
LIU Hui;GAO Jiangyan;HUO Lin;ZHANG Xiaoguang;ZHANG Huixiao;ZHANG Huan;FU Hongyi;WANG Xianlei;AN Hejuan;WANG Yong;LIU Rui;CHEN Suli;LI Weihong(Department of Infectious Diseases,Chest Hospital of Hebei Province,Shijiazhuang,Hebei 050041,China;Department of Oncology,Chest Hospital of Hebei Province,Shijiazhuang,Hebei 050041,China;Office of Total Quality Management,Chest Hospital of Hebei Province,Shijiazhuang,Hebei 050041,China;Division of Medical Affairs,Chest Hospital of Hebei Province,Shijiazhuang,Hebei 050041,China;Department of Tuberculosis,Chest Hospital of Hebei Province,Shijiazhuang,Hebei 050041,China)
出处
《国际检验医学杂志》
CAS
2024年第6期738-743,750,共7页
International Journal of Laboratory Medicine
基金
河北省医学科学研究重点课题计划项目(20160492)。
