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目的 探讨胸部CT联合血清微小核糖核酸（microRNA, miR）-146a、miR-124-3p检测对肺结核的临床诊断价值。方法 选取2021年7月至2024年7月商洛市中医医院收治的106例疑似结核病患者为研究对象，根据病理检查结果分为肺结核组（n=62）和非肺结核组（n=44）；另选择同期80例健康体检者为健康对照组。采用Logistic回归分析miR-146a、miR-124-3p与肺结核发病的关系；绘制受试者工作特征曲线评估miR-146a、miR-124-3p对肺结核的诊断价值；采用Kappa检验分析胸部CT、血清miR-146a及miR-124-3p联合诊断结果与病理检查结果的一致性。结果 3组间血清miR-146a（健康对照组：1.00±0.11；非结核组：0.71±0.09；肺结核组：0.88±0.10）、miR-124-3p（健康对照组：1.00±0.11；非结核组：0.66±0.08；肺结核组：0.81±0.09）水平比较，差异均具有统计学意义（均P<0.05）;Logistic回归显示，miR-146a(OR=0.665,95%CI:0.448～0.986)、miR-124-3p(OR=0.748,95%CI:0.597～0.937)均为肺结核发病的保护因素（P=0.042,0.012）。miR-146a与miR-124-3p诊断肺结核的曲线下面积分别为0.829、0.849；胸部CT与病理检查的Kappa值为0.622，具有较高一致性（P<0.05）；胸部CT联合血清miR-146a、miR-124-3p与病理检查的Kappa值为0.828，具有极高一致性（P<0.05）。3者联合诊断肺结核的特异度、阳性预测值及准确度显著高于单一方法（P<0.05）。结论 肺结核患者血清miR-146a、miR-124-3p水平显著降低，且胸部CT联合血清miR-146a、miR-124-3p检测可提高对肺结核的诊断准确性，具有一定临床应用价值。
Abstract：Objective To explore and analyze the clinical diagnostic value of chest computed tomography(CT) combined with serum microribonucleic acid(miR-146a) and miR-124-3p for pulmonary tuberculosis. Methods From July 2021 to July 2024, 106 patients with suspected tuberculosis admitted to our hospital were included as objects, and were assigned into tuberculosis group(n=62) and non tuberculosis group(n=44) according to their pathological test results. The 80 healthy individuals selected for medical examination were healthy controls. Logistic regression was applied to analyze the effects of miR-146a and miR-124-3p on pulmonary tuberculosis. The receiver operating characteristic(ROC) curve was plotted to analyze the diagnostic value of miR-146a and miR-124-3p for pulmonary tuberculosis. Kappa was applied to analyze the consistency between the combined examination of chest CT, serum miR-146a and miR-124-3p and the pathological examination results.. Results The differences in serum miR-146a(1.00±0.11 vs. 0.71±0.09 vs. 0.88±0.10) and miR-124-3p(1.00±0.11 vs. 0.66±0.08 vs. 0.81±0.09) levels between the healthy control group, the non-tuberculosis group, and the pulmonary tuberculosis group were statistically significant(all P<0.05) MiR-146a [OR, 95%CI(0.665, 0.448-0.986)] and miR-124-3p [OR, 95%CI(0.748, 0.597-0.937)] were both protective factors that affected the occurrence of pulmonary tuberculosis(P=0.042, 0.012). ROC curve results showed that the AUC for diagnosing pulmonary tuberculosis using miR-146a and miR-124-3p was 0.829 and 0.849, respectively. Chest CT had a high concordance Kappa value of 0.622 when compared to pathologic examination(P<0.05). The combined detection of chest CT, serum miR-146a and miR-124-3p had extremely high consistency with pathological examination, with a Kappa value of 0.828(P<0.05). The specificity, positive predictive value, and accuracy of the combination of the three in diagnosing pulmonary tuberculosis were obviously higher than those of chest CT, miR-146a, and miR-124-3p alone(P<0.05). Conclusion The levels of serum miR-146a and miR-124-3p are reduced in patients with pulmonary tuberculosis, and chest CT combined with serum miR-146a and miR-124-3p has certain clinical value in the diagnosis of pulmonary tuberculosis.
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基本信息:
中图分类号:R521
引用信息:
[1]郭洲,詹昭昭.胸部CT联合血清miR-146a、miR-124-3p对肺结核的诊断价值[J].传染病信息,2026,39(01):51-56.
2026-02-28
2026-02-28