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[血清可溶性髓系细胞触发受体-1、可溶性白细胞分化抗原14亚型及γ-干扰素水平在布鲁氏菌病患者中的诊断价值]

[The Diagnostic Value of Serum sTREM-1, Presepsin and IFN-Gamma Levels in Brucellosis Patients].

作者信息

Yanik Ayten, Alay Handan, Laloğlu Esra

机构信息

Atatürk University Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Erzurum, Türkiye.

Atatürk University Faculty of Medicine, Department of Medical Biochemistry, Erzurum, Türkiye.

出版信息

Mikrobiyol Bul. 2024 Oct;58(4):422-432. doi: 10.5578/mb.20249699.

Abstract

Brucellosis is a zoonotic disease that causes high rates of morbidity and mortality due to difficulties in diagnosis and inadequate treatment. The purpose of this study was to assess the diagnostic significance of presepsin, trigger receptor expressed on soluble myeloid cells-1 (sTREM-1), and interferon-gamma (IFN-gamma) levels in patients with brucellosis. One hundred twenty-one brucellosis patients aged 18 or over and 39 healthy volunteers were included in this prospective study. The cases were classified as either acute, subacute or chronic according to the duration of symptoms. Serum was separated from blood samples taken from all groups and presepsin, sTREM-1, and IFN-gamma levels were determined before treatment. Serum presepsin, sTREM-1, and IFN-gamma levels were all significantly elevated in patients with Brucellosis compared to the control group (p< 0.05). Serum presepsin and sTREM-1 levels were also significantly higher in patients with acute brucellosis compared to the subacute and chronic groups (p< 0.05). The lowest serum IFN-gamma levels were observed in the chronic Brucellosis group. Significant moderately strong, positive correlations were determined between presepsin and sTREM-1 and IFN-gamma values (r= 0.695, r= 0.769, p< 0.001). Significant low-level positive correlations were observed between presepsin and AST, BUN and CRP (r= 0.215, r= 0.214, and r= 0.279, respectively p< 0.05). Higher serum presepsin levels were determined in patients with positive blood cultures than in those with no blood culture growth (p< 0.05). At a threshold value of 469.43 pg/mL, the presepsin test exhibited 95% sensitivity and 89% specificity in differentiating cases of Brucellosis from the healthy group. At a threshold value of 27.14 pg/mL, the sTREM-1 test exhibited 93% sensitivity and 84% specificity in differentiating Brucellosis cases from the healthy control group. Serum presepsin, sTREM-1 and IFN-gamma levels may be helpful in distinguishing patients with Brucellosis from healthy individuals and in differentiating between acute, subacute, and chronic Brucellosis.

摘要

布鲁氏菌病是一种人畜共患病,由于诊断困难和治疗不充分,导致发病率和死亡率很高。本研究的目的是评估可溶性髓系细胞触发受体-1(sTREM-1)、前降钙素和干扰素-γ(IFN-γ)水平在布鲁氏菌病患者中的诊断意义。这项前瞻性研究纳入了121名18岁及以上的布鲁氏菌病患者和39名健康志愿者。根据症状持续时间将病例分为急性、亚急性或慢性。从所有组采集的血液样本中分离出血清,并在治疗前测定前降钙素、sTREM-1和IFN-γ水平。与对照组相比,布鲁氏菌病患者的血清前降钙素、sTREM-1和IFN-γ水平均显著升高(p<0.05)。与亚急性和慢性组相比,急性布鲁氏菌病患者的血清前降钙素和sTREM-1水平也显著更高(p<0.05)。慢性布鲁氏菌病组的血清IFN-γ水平最低。在前降钙素与sTREM-1以及IFN-γ值之间确定了显著的中度强正相关(r=0.695,r=0.769,p<0.001)。在前降钙素与AST、BUN和CRP之间观察到显著的低水平正相关(分别为r=0.215,r=0.214和r=0.279,p<0.05)。血培养阳性患者的血清前降钙素水平高于血培养无生长的患者(p<0.05)。在前降钙素检测中,阈值为469.43 pg/mL时,区分布鲁氏菌病病例与健康组的灵敏度为95%,特异度为89%。在sTREM-1检测中,阈值为27.14 pg/mL时,区分布鲁氏菌病病例与健康对照组的灵敏度为93%,特异度为84%。血清前降钙素、sTREM-1和IFN-γ水平可能有助于区分布鲁氏菌病患者与健康个体,并区分急性、亚急性和慢性布鲁氏菌病。

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