新发传染病电子杂志2025，Vol.10Issue(5)：53-58,6.DOI:10.19871/j.cnki.xfcrbzz.2025.05.010
分子诊断技术联合相关细胞因子表达水平检测对肺结核与非结核分枝杆菌肺病的鉴别诊断价值分析
Analysis of the diagnostic value of molecular diagnostic techniques combined with cytokine expression for differentiating pulmonary tuberculosis from nontuberculous mycobacterial lung infections
摘要
Abstract
Objective To investigate the diagnostic efficacy of integrating molecular diagnostic methods with cytokine expression for distinguishing from pulmonary tuberculosis and nontuberculous mycobacterial(NTM)lung disease.Method A study was carried out to retrospectively analyze the clinical data of 70 patients diagnosed with pulmonary tuberculosis(referred to as the observation group)and 40 patients with NTM lung disease(the control group)treated at our hospital between January 2022 and July 2024.All individuals underwent testing using Xpert MTB/RIF Ultra,and their peripheral blood serum cytokine expression profiles were assessed,including interleukin(IL)-2,IL-4,IL-5,IL-6,IL-10,IL-12/23p40,IL-17 and tumor necrosis factor α(TNF-α).Binary logistic regression analysis was performed to investigate risk factors risk factors closely associated with the accurate identification of pulmonary tuberculosis.The effectiveness of each risk factor in combination for discriminating pulmonary tuberculosis was assessed using methods such as the receiver operating characteristic(ROC)curve,calibration curve,and decision curve analysis(DCA).Result The detection rate of Xpert MTB/RIF Ultra testing and the mean levels of IL-4,IL-6,and IL-12/23p40 in the observation group were significantly higher compared to those in the control group,whereas the mean level of TNF-α was significantly lower than that in the control group(P＜0.05).Univariate and multivariate logistic regression analysis demonstrated that Xpert MTB/RIF Ultra testing,IL-6,IL-12/23p40,and TNF-α were independent factors influencing the diagnosis of pulmonary tuberculosis(P＜0.05).The ROC curve analysis revealed that the AUC(95%CI)for the combined differential diagnosis of pulmonary tuberculosis utilizing Xpert MTB/RIF Ultra testing,IL-6,IL-12/23p40,and TNF-α was 0.889(0.821-0.957).Both the calibration curve and DCA curve confirmed that the combined diagnostic model based on these parameters exhibited high accuracy and substantial clinical returns.Conclusion The efficacy of the model utilizing the molecular diagnostic method Xpert MTB/RIF Ultra together with IL-6,IL-12/23p40,and TNF-α in discriminating between pulmonary tuberculosis and NTM lung disease is considerable.关键词
肺结核/非结核分枝杆菌/分子诊断技术/细胞因子/鉴别诊断Key words
Pulmonary tuberculosis/Nontuberculous mycobacteria/Molecular diagnostic techniques/Cytokines/Differential diagnosis分类
医药卫生引用本文复制引用
赵云,徐芳,王琛,盛芳..分子诊断技术联合相关细胞因子表达水平检测对肺结核与非结核分枝杆菌肺病的鉴别诊断价值分析[J].新发传染病电子杂志,2025,10(5):53-58,6.基金项目
张家港市科技局项目(ZKYL2461) （ZKYL2461）
