人血清单核细胞趋化蛋白1水平与脊柱结核易感性

背景：研究表明单核细胞趋化蛋白1基因多态性与脊柱结核易感性相关。目的：探讨湖南汉族人群血清趋化因子单核细胞趋化蛋白1表达水平与脊柱结核易感性的关系。方法：连续纳入2004年12月至2010年12月中南大学湘雅医院收治的湖南汉族新发脊柱结核患者及健康志愿者，抽取受试者清晨空腹外周静脉血2 mL，应用PCR和DNA直接测序法检测受试者单核细胞趋化蛋白1-362位点的基因型，应用酶联免疫吸附试验检测受试者血清单核细胞趋化蛋白1水平。运用ROC曲线进行诊断性检验，计算血清单核细胞趋化蛋白1水平对脊柱结核的诊断阈值并分析诊断效价。结果与结论：共纳入符合条件的脊柱结核患者208例，健康志愿者210名。脊柱结核患者血清单核细胞趋化蛋白1水平显著高于健康志愿者[（134.58±51.63） ng/L vs.（39.18±17.45） ng/L，P〈0.05]。且血清单核细胞趋化蛋白1水平不受性别影响，但在单核细胞趋化蛋白1-362-CC基因型人群中表达显著增高。当受试者血清单核细胞趋化蛋白1大于101.65 ng/L时，提示受试者可能已经罹患脊柱结核（敏感度：85.5%，特异度：94.3%，约登指数：0.799，ROC曲线下面积：0.946，95%可信区间：0.916-0.975，P 〈0.01）。可见在湖南汉族人群中，血清单核细胞趋化蛋白1水平与脊柱结核的易感性相关，高表达的血清单核细胞趋化蛋白1可作为诊断脊柱结核的指标之一。

Serum monocyte chemoattactant protein-1 level and spinal tuberculosis susceptibility

BACKGROUND：The monocyte chemoattactant protein-1 gene polymorphism is associated with spinal tuberculosis susceptibility. OBJECTIVE：To investigate the association between serum monocyte chemoattactant protein-1 expression level and spinal tuberculosis susceptibility in Han population of Hunan province. METHODS：The patients with spinal tuberculosis and the healthy volunteers were recruited in Xiangya Hospital of Central South University from December 2004 to December 2010. The empty peripheral venous blood 2 mL were col ected from the subjects in early morning, then the monocyte chemoattactant protein-1-362 genotypes were detected by polymerase chain reaction and DNA sequencing technology. And the serum monocyte chemoattactant protein-1 level was detected by enzyme linked immunosorbent assay technology. The ROC curve was used for diagnostic tests to calculate diagnostic threshold value of serum monocyte chemoattactant protein-1 level to spinal tuberculosis susceptibility, and to analyze the diagnostic titer. RESULTS AND CONCLUSION：208 patients with spinal tuberculosis and 210 healthy volunteers were included. The serum monocyte chemoattactant protein-1 level of the spinal tuberculosis patients was significantly higher than that of the healthy volunteers [（134.58±51.63） ng/L vs. （39.18±17.45） ng/L, P〈0.01]. The serum monocyte chemoattactant protein-1 level could not be affected by gender, but over-expressed in patients with monocyte chemoattactant protein-1-362-CC genotypes. The serum monocyte chemoattactant protein-1 level higher than 101.65 ng/L indicated that the patients might suffered from spinal tuberculosis （sensitivity：85.5%, specificity：94.3%, Youden index：0.799, area under curve of ROC：0.946, 95%confidence interval：0.916-0.975, P〈0.01）. The serum monocyte chemoattactant protein-1 level may be associated with spinal tuberculosis susceptibility in Han population of Hunan province, highly expressed serum monocyte chemoattactant protein-1 can be used as one of the indicators for the diagnosis of spinal tuberculosis.