外周血血清sTREM-1、Treg/Th17、miR-99b与耐多药结核病相关性及联合预测疗效的ROC分析-现代医学

外周血血清sTREM-1、Treg/Th17、miR-99b与耐多药结核病相关性及联合预测疗效的ROC分析

单位：1. 常德市第一中医医院检验科, 湖南常德 415000;
2. 邵东市人民医院检验科, 湖南邵阳 422800

关键词：可溶性髓系细胞触发受体-1 调节性T细胞/辅助性T细胞17 miR-99b 耐多药结核病相关性联合预测

分类号：R521

出版年·卷·期（页码）：2021·49·第十期（1176-1182）

摘要：

目的：探讨外周血血清可溶性髓系细胞触发受体-1（sTREM-1）、调节性T细胞/辅助性T细胞17（Treg/Th17）、微小RNA-99b （miR-99b）与耐多药结核病（MDR-TB）相关性及联合预测疗效价值。方法：选取2017年4月至2020年1月常德市第一中医医院收治的79例MDR-TB患者（MDR组）、85例非MDR-TB患者（非MDR组）及体检中心60例健康体检人群（对照组）。比较3组外周血血清sTREM-1、Treg/Th17、miR-99b水平，采用多因素Logistic回归方程分析各指标与MDR-TB的关系，比较MDR组不同疗效者基线资料及外周血血清sTREM-1、Treg/Th17、miR-99b水平，并比较不同外周血血清sTREM-1、Treg/Th17、miR-99b水平者转阴率，采用受试者工作特征曲线（ROC曲线）及曲线下面积（AUC）分析各指标预测转阴的价值。结果：MDR组外周血血清sTREM-1、miR-99b水平高于非MDR组和对照组，Treg/Th17水平低于非MDR组和对照组（P<0.05）；非MDR组外周血血清sTREM-1、miR-99b水平高于对照组，Treg/Th17水平低于对照组（P<0.05）；经多因素Logistic回归方程分析，外周血血清sTREM-1、miR-99b、Treg/Th17均为MDR-TB发生的影响因素（P<0.05）；肺结核转阴者外周血血清sTREM-1、miR-99b水平低于未转阴者，Treg/Th17水平高于未转阴者（P<0.05）；外周血血清sTREM-1、miR-99b高水平者转阴率低于低水平者，Treg/Th17高水平者转阴率高于低水平者（P<0.05）；经ROC曲线分析，外周血血清sTREM-1、miR-99b、Treg/Th17联合应用预测转阴的AUC值高于单一检测（P<0.05）。结论：MDR-TB患者外周血血清sTREM-1、Treg/Th17、miR-99b水平呈明显异常变化，与MDR-TB发生、疗效具有密切关联性，对临床MDR-TB治疗具有一定指导作用。

Objective: To explore the relationship between peripheral blood serum soluble myeloid cell trigger receptor-1(sTREM-1), regulatory T cells/helper T cells 17(Treg/Th17), microRNA-99b(miR-99b) and the correlation of multi-drug resistant tuberculosis(MDR-TB) and the value of joint predictive efficacy.Methods: 79 MDR-TB patients(MDR group), 85 non-MDR-TB patients(non-MDR group) and 60 health checkups in the physical examination center(control group)admitted to Changde First Hospital of Traditional Chinese Medicine were selected from April 2017 to January 2020.The three groups of peripheral blood serum sTREM-1, Treg/Th17, miR-99b levels were compared, the multivariate Logistic regression equation was used to analyze the relationship between each index and MDR-TB, and the baseline data of patients with different therapeutic effects in the MDR group, peripheral blood serum sTREM-1, Treg/Th17 and miR-99b levels were compared, and the negative rate of patients with different peripheral blood serum sTREM-1, Treg/Th17 and miR-99b levels were compared, receiver operating characteristic(ROC) curve and area under ROC(AUC) were used to analyze each indicator predicts the value of turning negative. Results: The peripheral blood serum sTREM-1 and miR-99b levels in the MDR group were higher than those in the non-MDR group and the control group, Treg/Th17 was lower than that of the non-MDR group and the control group(P<0.05); The peripheral blood serum sTREM-1 and miR-99b levels of the non-MDR group were higher than those of the control group, and Treg/Th17 was lower than that of the control group(P<0.05); After multivariate logistic regression analysis, peripheral blood serum sTREM-1, miR-99b, and Treg/Th17 wereall the influencing factors of the occurrence of MDR-TB(P<0.05); peripheral blood serum sTREM-1, miR-99b levels werelower than those who had not turned negative, Treg/Th17 was higher than that who had not turned negative(P<0.05); those with high levels of sTREM-1 and miR-99b in peripheral blood had a lower conversion rate than those with low levels, and Treg/Th17 with high levels, the negative conversion rate was higher than that with the low level(P<0.05); by ROC curve analysis, AUC value of the combination of peripheral blood serum sTREM-1, miR-99b, and Treg/Th17 predicting the negative conversion was higher than that of the single test(P<0.05). Conclusion: Peripheral blood serum sTREM-1, Treg/Th17, miR-99b levels of MDR-TB patients show significant abnormal changes, which are closely related to the occurrence and efficacy of MDR-TB, and have certain indications for clinical MDR-TB treatment.

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