Department of Infectious Diseases, Linköping University Hospital, Linköping.
Department of Infectious Diseases, Linköping University Hospital, Linköping, Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden.
Int J Tuberc Lung Dis. 2019 Nov 1;23(11):1155-1161. doi: 10.5588/ijtld.18.0634.
To investigate how levels of the soluble urokinase plasminogen activator receptor (suPAR) and erythrocyte sedimentation rate (ESR) correlate with disease activity and prognosis in pulmonary tuberculosis (PTB). This was a retrospective analysis of patients with active PTB ( = 500) in Gondar, Ethiopia, for whom the suPAR ( = 301) and ESR ( = 330) were analysed at the start of treatment. Both biomarkers were available for 176 patients. Human immunodeficiency virus (HIV) status, chest X-ray (CXR) findings, classification according to the clinical TBscore and treatment outcome were all recorded. In a multivariable logistic regression analysis adjusted for age, sex and HIV status, surrogate markers of disease activity such as advanced CXR patterns correlated with increased levels of suPAR (adjusted OR [aOR] 8.24, < 0.001) and of ESR (aOR 1.63, = 0.030), whereas ESR only correlated significantly with a TBscore >6 points. Increased levels of both suPAR and ESR were associated with unsuccessful treatment outcomes (aOR 2.93, = 0.013; aOR 2.52, = 0.025). The highest quartile of suPAR (aOR 13.3, = 0.029) but not ESR levels correlated independently with increased mortality. SuPAR and ESR levels correlate with disease activity in PTB; however, the clinical role of these potentially prognostic biomarkers needs to be verified in prospective studies.
为了研究可溶性尿激酶型纤溶酶原激活物受体（suPAR）和红细胞沉降率（ESR）的水平与肺结核（PTB）的疾病活动度和预后的相关性。这是对埃塞俄比亚贡德尔活动性肺结核（PTB）患者（n = 500）的回顾性分析，在治疗开始时分析了这些患者的 suPAR（n = 301）和 ESR（n = 330）。有 176 名患者的两种生物标志物都可用。记录了人类免疫缺陷病毒（HIV）状态、胸部 X 光（CXR）检查结果、根据临床 TBscore 的分类以及治疗结果。在调整年龄、性别和 HIV 状态的多变量逻辑回归分析中，疾病活动的替代标志物，如先进的 CXR 模式，与 suPAR 水平升高（调整后的比值比[aOR] 8.24，<0.001）和 ESR（aOR 1.63，= 0.030）相关，而 ESR 仅与 TBscore >6 点显著相关。suPAR 和 ESR 水平的升高与治疗结果不佳相关（aOR 2.93，= 0.013；aOR 2.52，= 0.025）。suPAR 的最高四分位数（aOR 13.3，= 0.029）而非 ESR 水平与死亡率的增加独立相关。suPAR 和 ESR 水平与 PTB 的疾病活动度相关；然而，这些潜在预后生物标志物的临床作用需要在前瞻性研究中得到验证。
