肺结核患者血清骨桥蛋白检测及临床意义

目的 了解骨桥蛋白(OPN)在肺结核中的临床意义.方法 对80例抗结核治疗前肺结核患者病例组,其中单纯肺结核60例(单纯肺结核组),肺结核合并结核性胸膜炎20例(肺结核合并胸膜炎组)]血清OPN水平进行检测,并与30例健康体检者(健康对照组)、20例有效抗结核治疗随访6个月后的患者(随访组)进行对比,同时依据临床常用结核检测指标研究OPN的临床意义.结果 病例组血清OPN水平(843.49±569.23) ng/L]较健康对照组(352.50±185.02) ng/L]明显升高,差异有统计学意义(P＜0.05).随访组治疗后血清OPN水平(494.11±352.40) ng/L]较治疗前(1106.60±628.39) ng/L]明显降低,差异有统计学意义(P＜0.05).随访组治疗后血清OPN水平与健康对照组比较差异无统计学意义(P＞0.05).肺结核合并胸膜炎组血清OPN水平(1179.80±606.33) ng/L]高于单纯肺结核组(727.53±511.66) ng/L],差异有统计学意义(P＜0.05)；而且两组OPN水平均高于健康对照组,差异有统计学意义(P＜0.05).单纯肺结核组患者有空洞者血清OPN水平 (836.51±549.80) ng/L]高于无空洞者(535.52±375.95)ng/L],差异有统计学意义(P＜0.05)；病变范围累及＜3叶与≥3叶患者、痰结核菌阳性与阴性患者、结明试验阳性与阴性患者、红细胞沉降率升高与正常患者、PPD强阳性与非强阳性患者血清OPN水平比较差异均无统计学意义(P＞0.05).结论 OPN与肺结核活动性密切相关,血清OPN水平可以作为判断肺结核活动、病情转归的临床指标,血清OPN水平与肺结核病情严重程度有一定相关性.

Determination of serum osteopontin in pulmonary tuberculosis patients and its clinical significance

Objective To investigate osteopontin (OPN) level in pulmonary tuberculosis and its clinical significance.Methods The level of serum OPN was determined in 80 pulmonary tuberculosis patients before anti-tuberculosis treatment patients group,simple pulmonary tuberculosis with 60 cases (simple pulmonary tuberculosis group),pulmonary tuberculosis combined with tuberculous pleurisy with 20cases (pulmonary tuberculosis combined with tuberculous pleurisy group)],and compared with that of 30healthy persons (healthy control group) and 20 patients having received effective anti-tuberculosis treatment and followed-up for 6 months (followed-up group).At the same time,the clinical significance of OPN was studied by other commonly used clinical indicators of tuberculosis.Results The level of serum OPN in patients group (843.49 ±569.23) ng/L] was significantly higher than that in healthy control group (352.50 ± 185.02) ng/L,P ＜0.05].The level of serum OPN after treatment in followed-up group were significantly decreased compared with those before treatment (494.11 ±352.40) ng/L vs.(1106.60 ± 628.39) ng/L,P＜ 0.05 ] and there was no significant difference compared with those in healthy control group (P ＞ 0.05 ).The level of serum OPN in pulmonary tuberculosis combined with tuberculous pleurisy group (1179.80 ±606.33) ng/L] was significantly higher than those in simple pulmonary tuberculosis group (727.53 ±511.66) ng/L,P ＜0.05],and they were both higher than those in healthy control group ( 352.50 ± 185.02 ) ng/L,P ＜ 0.05 ].Therefore,for further additional subgroup analysis in simple pulmonary tuberculosis group,the level of serum OPN in patients with cavity ( 836.51 ± 549.80) ng/L ] was significantly higher than that without cavity (535.52 ± 375.95 ) ng/L,P ＜ 0.05 ],while the levels of serum OPN had no statistical difference between pulmonary lesion involved ＜ 3 leaf patients and ≥ 3 leaf patients,sputum mycobacterium tuberculosis positive patients and negative patients,mycoDot test results positive patients and negative patients,erythrocyte sedimentation rate elevated patients and normal patients,PPD strongly positive patients and non-strongly positive patients (P＞0.05).Conclusions OPN activity is closely related with pulmonary tuberculosis.OPN can serve as a judge of pulmonary tuberculosis and the clinical indicators of disease outcome.The level of serum OPN and the severity of pulmonary tuberculosis have some correlations.