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目的研究sICAM-1、sIL-2R在肺结核菌阳、菌阴及健康对照人群中的相关性,探讨sI-CAM-1与sIL-2R指标诊断结核病的最优灵敏度和特异度的截值点。方法采用酶联免疫吸附法(ELISA)测定97例在江苏省昆山市第一人民医院及乡镇医院就诊年龄在20~60岁的新发肺结核患者(53例菌阳、44例菌阴)及经年龄频数(±3岁)、同性别匹配的93例正常健康人的血清sICAM-1、sIL-2R水平。计算sICAM-1、sIL-2R在肺结核菌阳、菌阴及健康对照人群中的pearson相关系数,采用ROC曲线探索sICAM-1、sIL-2R诊断结核病的最优灵敏度和特异度的截值点。结果在菌阴患者中,sICAM-1与sIL-2R呈显著的正相关关系(r=0.4639,P=0.0017)。而菌阳患者和健康人群中,两者无明显的线性相关关系,相关系数分别为0.047 2(P=0.7397)、-0.0077(P=0.9419)。sICAM-1诊断结核病的最优截值点为:364.04ng/ml,灵敏度为83.0%,特异度为83.9%,sIL-2R诊断结核病的最优截值点为:2.49ng/ml,,灵敏度为63.9%,特异度为64.8%。结论sICAM-1水平≥364.04ng/ml可作为诊断结核病的一个辅助参考指标。
Objective To study the correlation between sICAM-1 and sIL-2R in patients with positive pulmonary tuberculosis, bacteria negative and healthy controls and to investigate the optimal sensitivity and specificity of sI-CAM-1 and sIL-2R in the diagnosis of tuberculosis. Methods Ninety-seven cases of newly diagnosed pulmonary tuberculosis (53 cases of bacilli and 44 cases of fungus) and 20 cases of age-matched tuberculosis (20 cases) were treated in the First People’s Hospital of Kunshan, Jiangsu Province and township hospitals by enzyme-linked immunosorbent assay (ELISA) Serum levels of sICAM-1 and sIL-2R were detected in age-matched (± 3-year-old) and sex-matched 93 healthy volunteers. The Pearson correlation coefficient of sICAM-1 and sIL-2R in tuberculosis bacilli, bacteria yin and healthy controls was calculated. The optimal sensitivity and specificity cut-off points of sICAM-1 and sIL-2R in tuberculosis diagnosis were determined by ROC curve. Results There was a significant positive correlation between sICAM-1 and sIL-2R in patients with bacilli (r = 0.4639, P = 0.0017). However, there was no significant linear correlation between the two groups of patients with positive bacilli and healthy people, the correlation coefficients were 0.047 2 (P = 0.7397) and -0.0077 (P = 0.9419) respectively. The optimal cut-off point of sICAM-1 for diagnosis of tuberculosis was 364.04ng / ml, the sensitivity was 83.0% and the specificity was 83.9%. The optimal cut-off point of sIL-2R for diagnosis of tuberculosis was 2.49ng / ml and the sensitivity was 63.9%, specificity was 64.8%. Conclusion The sICAM-1 level of 364.04 ng / ml can be used as an auxiliary reference for the diagnosis of tuberculosis.