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目的 探讨肺结核(tuberculosis, TB)患者血清中涎液化糖链抗原(krebs von den lungen-6, KL-6)、T细胞免疫球蛋白及粘蛋白域蛋白-4(T-cell immunoglobulin and mucin domain-containing molecule-4, TIM-4)水平与病情程度及不良预后的关系。方法 选取2021年7月至2023年7月期间在江苏省人民医院溧阳分院诊治的158例TB患者为观察组，并选取同期在我院进行健康体检的158例健康者作为对照组。采用Bandim结核病评分标准对TB患者病情程度进行评估，将其分为重症组(n=61)和轻症组(n=97)；根据患者预后情况，分为良好组(n=101)与不良组(n=57)；采用Logistic回归分析TB患者预后影响因素；通过Spearman相关分析评估血清KL-6和TIM-4水平与TB病情程度的相关性；利用受试者工作特征曲线评价血清KL-6和TIM-4对TB患者预后的预测效能。结果 观察组血清KL-6和TIM-4水平均显著高于对照组(均P<0.05)；与轻症组相比，重症组血清KL-6和TIM-4水平均明显升高(均P<0.05)；不良组血清KL-6和TIM-4水平均明显高于预后良好组(均P<0.05)；血清KL-6、TIM-4水平均是TB患者不良预后的独立影响因素(均P<0.05)；血清KL-6、TIM-4预测TB患者预后的曲线下面积(area under curve, AUC)分别为0.789、0.803,2者联合预测的AUC为0.914,2者联合预测效能优于任一单一指标(z2者联合-KL-6=3.375,P=0.001;z2者联合-TIM-4=3.514,P=0.000)。结论 TB患者血清KL-6、TIM-4水平升高，与患者病情严重程度及不良预后密切相关，且2者联合预测对TB患者不良预后具有较高的预测价值。
Abstract：Objective To explore the correlation between levels of serum Krebs Von den Lungen-6(KL-6), T-cell immunoglobulin and mucin domain-containing molecule-4(TIM-4) and the severity and poor prognosis of pulmonary tuberculosis(TB) patients. Methods From July 2021 to July 2023, 158 TB patients who visited Liyang Branch of Jiangsu Provincial People's Hospital were regarded as the TB group, and another 158 healthy people who underwent physical checkups were as the control group. Disease severity was assessed using the Bandim tuberculosis score, classifying patients into severe(n=61) and mild(n=97) groups. According to the prognosis, patients were divided into favorable(n=101) and poor(n=57) prognosis groups. Logistic regression analysis was used to analyze the influencing factors of prognosis of TB patients; Spearman's correlation analysis was used to analyze the correlation between serum KL-6 and TIM-4 levels and the severity of the TB, and the receiver operating characteristic curve was used to analyze the predictive efficiency of serum KL-6 and TIM-4 for prognosis of TB patients. Results Compared with the control group, the levels of serum KL-6 and TIM-4 in the TB group were markedly higher(P<0.05). Serum levels of KL-6 and TIM-4 were significantly elevated in the severe group compared to the mild group(P<0.05). Compared with the favorable group, the levels of serum KL-6 and TIM-4 in the poor group were significantly higher(P<0.05). Serum KL-6 and TIM-4 levels were both independent influencing factors for the poor prognosis of TB patients(P<0.05). The area under the curve(AUC) of serum KL-6 and TIM-4 in predicting the prognosis of TB patients was 0.789 and 0.803, respectively, the AUC of their combination was 0.914, and the predictive power of the combination was better than that of any single indicator(zcombination-KL-6=3.375, P=0.001, zcombination-TIM-4=3.514, P=0.000). Conclusion The levels of serum KL-6 and TIM-4 in TB patients increase, and they are closely related to the severity of disease and poor prognosis. Moreover, the combined prediction of these two biomarkers has a high predictive value for the poor prognosis of TB patients.
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基本信息:
中图分类号:R521
引用信息:
[1]陈洁,孙逸贰,张红陶,等.血清KL-6、TIM-4水平与肺结核病情严重程度及预后的相关性研究[J].传染病信息,2026,39(01):57-61.
2026-02-28
2026-02-28