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目的 探讨肺结核（tuberculosis, TB）患者血清烟酰胺腺嘌呤二核苷酸磷酸氧化酶4(nicotinamide adenine dinucleotide phosphate oxidase 4, NOX-4)、程序性细胞死亡因子4(programmed cell death factor 4, PDCD4)的表达水平及其对病情严重程度的评估价值。方法 选取邯郸市传染病医院2023年5月至2025年5月接诊的121例TB患者为病例组，根据病情严重程度将病例组分为重度组（n=48）与轻度组（n=73）。另选取115例同期进行体检的健康者为对照组。采用ELISA法检测血清NOX-4、PDCD4的表达水平。采用相对危险度分析血清NOX-4、PDCD4水平对TB患者病情严重程度的影响。采用多因素Logistic回归分析TB患者病情严重程度的影响因素；采用受试者工作特征（receiver operating characteristic, ROC）曲线分析血清NOX-4、PDCD4对TB患者病情严重程度的评估价值。结果 与对照组相比，病例组血清NOX-4水平较高，血清PDCD4水平较低（均P<0.05）。重度组C反应蛋白（C-reactive protein, CRP）、降钙素原（procalcitonin, PCT）、干扰素-γ(interferon-γ, IFN-γ)及血清NOX-4水平均高于轻度组，血清PDCD4水平低于轻度组（均P<0.05）。血清NOX-4高水平患者发生重度的风险是低水平患者的3.989倍（95%CI:2.123～7.498），血清PDCD4低水平患者发生重度的风险是高水平患者的3.201倍（95%CI:1.808～5.665）。多因素Logistic回归分析显示，CRP、IFN-γ、PCT、血清NOX-4及PDCD4均为TB患者病情严重程度的独立影响因素（均P<0.05）。ROC曲线分析显示，血清NOX-4、PDCD4及两者联合评估TB患者病情严重程度的曲线下面积分别为0.860、0.852、0.934，联合评估的效能优于单独评估（Z=2.034、2.650,P=0.042、0.008），联合评估的灵敏度、特异度分别为91.67%、82.19%。结论 TB患者血清NOX-4水平显著升高，血清PDCD4水平显著降低，两者均与病情严重程度紧密联系，联合检测对TB患者病情严重程度具有较高的评估价值。
Abstract：Objective This study aimed to investigate the serum expression levels of nicotinamide adenine dinucleotide phosphate oxidase 4(NOX-4) and programmed cell death 4(PDCD4) in patients with pulmonary tuberculosis(TB), and to explore their clinical value in evaluating severity of disease. Methods From May 2023 to May 2025, 121 TB patients admitted to our hospital were considered as the case group, and further stratified into severe group(n=48) and mild group(n=73) based on severity of disease. Meanwhile, another 115 healthy control who underwent physical check ups were considered as the control group. ELISA method was used to detect serum NOX-4 and PDCD4. Relative risk was used to discuss the impact of different levels of serum NOX-4 and PDCD4 on the TB severity. Multivariate Logistic regression analysis was utilized to identify independent risk factors associated with TB severity. Receiver operating characteristic(ROC) curves were plotted to assess the diagnostic efficacy of serum NOX-4 and PDCD4 for distinguishing severe from mild TB. Results Compared with the control group, the case group had higher serum NOX-4 and lower serum PDCD4(P<0.05). The severe group had higher C-reactive protein(CRP), procalcitonin(PCT), interferon-γ(IFN-γ), and serum NOX-4, and higher serum PDCD4 than the mild group(P<0.05). The risk of severe disease in patients with high level of serum NOX-4 was 3.989 times higher than in patients with low level, and the risk of severe disease in patients with low level of serum PDCD4 was 3.201 times higher than patients with high level. CRP, IFN-γ, PCT, serum NOX-4 and PDCD4 were influencing factors on the severity of TB(P<0.05). The area under the curve(AUC) values of serum NOX-4, PDCD4, and their union in assessing the severity of TB were 0.860, 0.852, and 0.934, respectively, the union was superior to the individual assessments(Z=2.034, 2.650; P=0.042, 0.008), and the sensitivity and specificity of the united assessment were 91.67% and 82.19%, respectively. Conclusion Serum NOX-4 is prominently elevated and serum PDCD4 is prominently reduced in TB patients, which is closely related to the severity of disease. In addition, the united detection of the two has higher assessment value for the severity of TB patients.
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基本信息:
中图分类号:R521
引用信息:
[1]苗艳红,李继翰,吴志昆,等.肺结核患者血清NOX-4、PDCD4的表达及其临床意义[J].传染病信息,2026,39(03):279-284.
基金信息:
河北省中医药管理局中医药类科学研究课题（2023272）
2026-06-30
2026-06-30