摘要
目的:探讨肺结核患者外周血淋巴细胞亚群与抗结核药物性肝损伤(Anti-tuberculosis Drug-Induced Liver Injury,ATB-DILI)的相关性。方法:选取2024年1月至2024年12月本院收治的68例初治肺结核患者,依据是否发生ATB-DILI分为观察组(23例)和对照组(45例)。收集两组的一般资料及血清生化指标,进行外周血淋巴细胞亚群检测。结果:与对照组相比,观察组患者天门冬氨酸氨基转移酶(Aspartate Aminotransferase,AST)、丙氨酸氨基转移酶(Alanine Aminotransferase,ALT)水平以及CD8^(+)占比更高(P<0.05),CD4^(+)占比及CD4^(+)/CD8^(+)值更低;进一步Logistic回归分析显示,CD4^(+)、CD4^(+)/CD8^(+)是ATB-DILI的独立保护因素(P<0.05)。受试者工作特征曲线(Receiver Operating Characteristic,ROC)分析表明,单一CD4^(+)占比、CD4^(+)/CD8^(+)值预测ATB-DILI的曲线下面积(Area Under the Curve,AUC)分别为0.729、0.821,联合预测的AUC可提升至0.890,敏感度和特异度分别为86.96%、86.67%。结论:外周血淋巴细胞亚群与ATB-DILI的发生关系密切,CD4^(+)、CD4^(+)/CD8^(+)可作为预测ATB-DILI的潜在生物标志物,联合检测的预测效能可得到进一步提升。
Objective:To explore the association between peripheral blood lymphocyte subsets and Anti-tuberculosis Drug-Induced Liver Injury(ATB-DILI)in patients with pulmonary tuberculosis.Methods:A total of 68 newly treated pulmonary tuberculosis patients admitted to the hospital from January to December 2024 were selected.Participants were classified as ATB-DILI cases(n=23)or non-ATB-DILI controls(n=45).General information and serum biochemical indices of the two groups were collected.The levels of peripheral blood lymphocyte subsets were detected.Results:As compared with the control group,the observation group showed significant increases in the levels of Alanine Aminotransferase(ALT)and Aspartate Aminotransferase(AST)and the percentage of CD8^(+),as well as significant decreases in the percentage of CD4^(+)and CD4^(+)/CD8^(+)ratio(P<0.05).Logistic regression analysis showed that CD4^(+)and CD4^(+)/CD8^(+)ratio were independent protective factors for ATB-DILI(P<0.05).Receiver Operating Characteristic(ROC)curve analysis showed that the area under the curves(AUCs)of CD4^(+)percentage and CD4^(+)/CD8^(+)ratio for predicting ATB-DILI were 0.729 and 0.821,respectively.The AUC of combined prediction with the two increased to 0.890.The sensitivity and specificity were 86.96%and 86.67%,respectively.Conclusion:There is a close relationship between peripheral blood lymphocyte subsets and the occurrence of ATB-DILI.CD4^(+)and CD4^(+)/CD8^(+)ratio can serve as potential biomarkers for predicting ATB-DILI.Combined detection of the two can enhance predictive efficacy.
作者
夏建英
张亚兰
杨梦霞
Xia Jian-ying;Zhang Ya-lan;Yang Meng-xia(Department of Infectious Diseases,The Second People's Hospital of Shangrao,Shangrao 334000,Jiangxi,China)
基金
上饶市科技计划指导性项目(编号:20241CZDX88)。
关键词
肺结核
抗结核药物性肝损伤
生化指标
淋巴细胞亚群
相关性分析
Pulmonary tuberculosis
Anti-tuberculosis drug-induced liver injury
Biochemical index
Lymphocyte subset
Correlation analysis
