耐药结核分枝杆菌感染肺结核患者血清RBP-4、HP、PEPD、PGLYRP2水平及其与抗结核疗效的关系

Serum levels of RBP-4, HP, PEPD and PGLYRP2 and their relationships with anti-tuberculosis efficacy in patients infected with drug-resistant Mycobacterium tuberculosis

    摘要
  • 摘要:
    目的 探究耐药结核分枝杆菌感染肺结核患者血清视黄醇结合蛋白4(RBP-4)、触珠蛋白(HP)、脯氨酸肽酶(PEPD)、肽聚糖识别蛋白2(PGLYRP2)水平变化及其与抗结核疗效的关系。
    方法 于2020年8月-2023年9月期间, 将湖北省武汉市肺科医院(结核病防治所)收治的191例耐药肺结核患者为耐药组, 观察2月内痰菌阴转情况, 其中转阴组117例, 未转阴组74例；同时选取191例非耐药肺结核患者为非耐药组。比较耐药组、非耐药组及不同疗效组RBP-4、HP、PEPD、PGLYRP2水平变化, 利用Spearman分析RBP-4、HP、PEPD、PGLYRP2水平与耐药结核分枝杆菌感染的相关性；RBP-4、HP、PEPD、PGLYRP2水平联合检测对抗结核疗效的预测价值采用受试者工作特征(ROC)曲线进行分析。
    结果 耐药组RBP-4水平是(13.62±2.74)μg/ml低于非耐药组, HP、PEPD、PGLYRP2水平分别为(2.86±0.47)g/L、(1573.53±169.15)U/L、(563.29±64.20)pg/ml高于非耐药组(P＜0.05)。与未转阴组相比, 转阴组RBP-4水平升高, HP、PEPD、PGLYRP2水平降低(P＜0.05)。RBP-4水平与耐药结核分枝杆菌感染呈负相关, HP、PEPD、PGLYRP2水平与之则成正相关(P＜0.05)；与RBP-4、HP、PEPD、PGLYRP2单一检测预测抗结核疗效的曲线下面积(AUC)值相比, 四者联合检测的AUC值更高(P＜0.05), 且联合检测的敏感度和特异度为87.84%、84.62%。
    结论 耐药结核分枝杆菌感染肺结核患者RBP-4、HP、PEPD、PGLYRP2表达异常, 且四者与耐药结核分枝杆菌感染有相关性, 其联合检测预测患者抗结核疗效价值较高。

     

    Abstract:
    OBJECTIVE To investigate the changes of serum levels of retinol-binding protein 4 (RBP-4), haptoglobin (HP), proline peptidase (PEPD) and peptidoglycan recognition protein 2 (PGLYRP2) and their relationship with anti-tuberculosis efficacy in patients infected with drug-resistant Mycobacterium tuberculosis.
    METHODS From Aug. 2020 to Sep. 2023, total 191 patients with drug-resistant tuberculosis admitted in Wuhan Pulmonary Hospital of Hubei Province (Tuberculosis Prevention and Control Institute) were selected as the drug-resistant group and further divided into 117 cases of the negative conversion group and 74 cases of the non-negative conversion group according to the sputum results within 2 months. Another 191 patients with non-drug-resistant pulmonary tuberculosis were selected as the non-drug-resistant group. Levels of RBP-4, HP, PEPD and PGLYRP2 were compared among the groups, their correlations with drug-resistant M. tuberculosis infection were analyzed by Spearman, and their combined predictive value for the anti-tuberculosis efficacy was analyzed by receiver operating characteristic (ROC) curve.
    RESULTS Compared with the non-drug resistant group, RBP-4 level was low (13.62±2.74)μg/ml and HP, PEPD and PGLYRP2 levels were high (2.86±0.47)g/L, (1573.53±169.15)U/L and (563.29±64.20)pg/ml, respectively in the drug resistant group (all P < 0.05). Compared with the non-negative conversion subgroup, RBP-4 level increased and the levels of HP, PEPD and PGLYRP2 decreased in the negative conversion group (all P < 0.05). RBP-4 level was negatively correlated with the infection of drug-resistant M. tuberculosis, while the levels of HP, PEPD and PGLYRP2 were positively correlated (P < 0.05). The AUC value of the combined detection of RBP-4, HP, PEPD and PGLYRP2 was higher than that of single index in the prediction of anti-tuberculosis efficacy (P < 0.05), with the sensitivity and specificity of 87.84% and 84.62%, respectively.
    CONCLUSION RBP-4, HP, PEPD and PGLYRP2 express abnormally and are correlated with the infection of drug-resistant M. tuberculosis. Their combined detection has a high predictive value for the anti-tuberculosis efficacy of patients.

     

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