肺结核治疗过程中IL-6血清表达水平变化分析

doi:10.3969/j.issn.1006-5725.2023.19.004

Abstract

Abstract:

Objective To explore the trend and influencing factors of serum IL-6 level in the treatment of pulmonary tuberculosis. Methods The serum of 56 patients with pulmonary tuberculosis was collected before treatment， 2 months of treatment （the end of the intensive period） and 6 months of treatment， and the expression level of IL-6 was measured by flow cytometry. Results The expression level of IL-6 in serum during treatment in tuberculosis patients tended to decrease， and the expression level was statistically significant （P = 0.000）. ROC curve analysis showed that before treatment and 2 months of treatment， the subline area of IL-6 concentration difference in serum was 0.627， the cut-off value was 3.840， the sensitivity for discrimination was 71.40%， and the specificity was 51.80%. Binary logistic regression showed that whether the serum IL-6 concentration decreased to less than 3.840 pg/mL after 2 months of treatment was related to treatment cycle and age. The difference between the serum concentration of IL-6 before treatment was statistically significant between the group with or without cavitation， the treatment period group with 6 months and 12 months， and the group with no significant change in imaging lesions before treatment at 2 months， and the negative group with positive etiological test results before treatment. At 2 months of treatment， the difference between serum concentrations of IL-6 was statistically significant between different age groups， different treatment cycle groups， and the group with negative etiological test results before treatment and at 2 months of treatment. At 6 months of treatment， the difference between the serum concentration of IL-6 was statistically significant in the group with diabetes， in the group with different treatment cycles， and in the group with negative etiological test results at 6 months of treatment. ROC curve analysis showed that when the enrolled cases were limited to positive etiology before treatment， the off-line area of the difference in serum IL-6 concentration between 6 months of treatment and 2 months of treatment was 0.805， the cut-off value was 5.450， the sensitivity for discrimination was 81.25%， and the specificity was 75.00%. When the age of the enrolled cases was limited to 44 years and below， the off-line areas of IL-6 concentration differences in serum after 2 months of treatment and before treatment， 6 months of treatment and 2 months of treatment were 0.726 and 0.721， the cut-off values were 3.840 and 3.755， and the sensitivity and specificity were 70.59% and 67.65%， respectively. Conclusion During the treatment of pulmonary tuberculosis， the concentration of IL-6 in serum show a downward trend， and its level is related to whether the patient's lungs have cavities， etiological results， age， disease progression， and whether diabetes is present.

Key words: tuberculosis, IL-6, changes in expression level

Bei XIE,WanHua XU,Lan GONG,Yu YANG,Haiping DONG,ling WU,Fanrong MENG,Nan WANG,Zhihui LIU,Hua. LI. Analysis of changes in serum expression levels of IL-6 during pulmonary tuberculosis treatment[J]. The Journal of Practical Medicine, 2023, 39(19): 2434-2439.

Figures/Tables 5

Fig.1

Tab.1

Tab.2

Analysis of IL-6 expression levels in serum of pulmonary tuberculosis with different characteristics during treatment M（P25，P75）"

因素	例数（%）	治疗前	治疗2个月	治疗6个月	P值
性别
男	38（67.9）	4.94（3.90，10.64）	3.82（2.61，6.27）	3.47（2.57，4.81）
女	18（32.1）	4.31（3.05，8.53）	3.54（2.74，7.43）	3.42（2.72，4.63）
年龄					0.002^*，0.008^&&
≤ 44（青年）	34（60.7）	4.45（3.23，6.05）	3.24（2.53，4.12）^**&&	3.32（2.49，4.08）
45 ~ 59（中年）	10（17.9）	6.39（3.61，8.53）	5.51（4.26，7.57）^**	3.67（2.80，5.42）
≥ 60（老年）	12（21.4）	10.78（3.47，15.21）	6.18（3.33，16.65）^&&	4.14（2.76，7.59）
是否糖尿病					0.038^*
是	7（12.5）	8.34（5.69，18.26）	13.72（3.51，14.96）	5.42（3.42，7.32）^*
否	49（87.5）	4.63（3.29，7.67）	3.61（2.61，5.84）	3.42（2.57，4.40）
有无肺部空洞					0.021^*
有	6（10.7）	15.03（8.53，25.31）^*	3.80（3.04，7.57）	4.26（2.95，5.42）
无	50（89.3）	4.59（3.23，7.67）	3.72（2.61，6.27）	3.45（2.57，4.63）
治疗周期
6个月	19（33.9）	4.08（2.92，4.74）^***	3.19（2.12，5.05）^*	3.28（1.96，3.47）^**	0.000^**，0.04^，
9月	23（41.1）	4.54（3.57，9.35）	3.42（2.84，4.76）^&&	3.60（2.78，3.96）^&&	0.001^**；
12个月	14（25.0）	10.78（5.71，14.25）^***	7.09（4.12，14.00）^*&&	5.36（4.31，8.23）^**&&	0.009^&&
影像学
2个月/0月					0.004^**
病灶吸收	31（55.4）	5.71（4.10，11.17）^**	4.17（2.71，7.03）	3.42（2.55，5.27）
病灶增大	4（7.1）	9.96（4.12，15.78）	3.45（2.98，9.33）	3.61（2.41，4.61）
同前相似	21（37.5）	3.90（2.80，5.11）^**	3.61（2.61，4.26）	3.47（2.80，4.31）
6个月/2个月
病灶吸收	22（39.3）	5.63（4.07，11.02）	4.02（3.19，7.57）	3.54（2.61，4.81）
病灶增大	1（1.8）	338.40	361.92	114.72
同前相似	33（58.9）	4.17（3.23，6.66）	3.47（2.55，4.77）	3.42（2.72，4.63）
病原学检查
治疗0月					0.000^**，0.032^
阳性	16（28.6）	9.63（5.60，20.56）^***	5.48（3.52，10.58）^*	4.05（3.07，5.48）
阴性	40（71.4）	4.28（3.04，5.92）	3.41（2.61，4.76）	3.39（2.53，4.36）
治疗2个月					0.034^*
阳性	4（7.1）	9.63（6.91，174.66）	11.27（5.12，188.92）^*	4.81（3.49，60.13）
阴性	52（92.9）	4.59（3.21，8.44）	3.57（2.61，5.87）	3.42（2.59，4.69）
治疗6个月					0.022^*
阳性	6（10.7）	16.83（5.71，27.86）	9.81（5.05，15.91）	5.48（5.24，6.94）^*
阴性	50（89.3）	4.59（3.23，8.34）	3.54（2.61，5.84）	3.39（2.61，4.31）
治疗结束
阳性	3（5.4）	10.92（6.11，18.12）	3.61（2.69，8.67）	2.90（2.45，4.16）
阴性	53（94.6）	4.73（3.29，8.34）	3.78（2.67，6.27）	3.47（2.61，4.75）

Tab.2

Tab.3

Tab.4

References 20

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比较组	秩和检验		AUC（95% CI）	ROC曲线
比较组	Z	P	AUC（95% CI）	界值	灵敏度（%）	特异度（%）
2个月 vs. 治疗前	-2.325	0.020	0.627（0.523～0.730）	3.840	71.40	51.80
6个月 vs. 治疗前	-5.128	0.000	0.703（0.608～0.799）	5.685	30.40	87.50
6个月 vs. 2个月	-2.239	0.025	0.564（0.457～0.671）	3.810	71.40	62.50

治疗2个月后	影响因素	回归系数	标准误差	P值	OR（95%CI）	霍斯默-莱梅肖检验（P）
< 3.840	治疗周期			0.020		0.165
	9月	1.260	0.909	0.166	3.524（0.593～20.900）
	12个月	-2.976	1.308	0.023	0.051（0.004～0.660）
	年龄组			0.010
	中年	-4.000	1.373	0.004	0.018（0.001～0.270）
	老年	-1.798	0.989	0.069	0.166（0.024～1.150）
	常量	0.158	0.614	0.797	1.172

病例类型	比较组	AUC（95% CI）	界值	灵敏度（%）	特异度（%）
治疗前细菌学阳性	6个月 vs. 2个月	0.805（0.647 ~ 0.962）	5.450	81.25	75.00
年龄（≤ 44）	2个月 vs. 治疗前	0.726（0.605 ~ 0.848）	3.840	70.59	70.59
年龄（≤ 44）	6个月 vs. 2个月	0.721（0.600 ~ 0.842）	3.755	70.59	67.65

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Analysis of changes in serum expression levels of IL-6 during pulmonary tuberculosis treatment

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