| Objective:To detect the concentration differences of the research objects’peripheral blood cytokines of IL-2,IL-4,IL-6,IL-10,IFN-γ,TNF-α and IL-17 levels by using BD-Pharmingen Cytometric Bead Array(BD CBA).The concentration differences were used to discuss the value of Cytometric Bead Array in the diagnosis of tuberculosis.Meanwhile,to detect the peripheral blood of pulmonary tuberculosis patients by using T-SPOT and to detect the mycobacterium nucleic acid content of sputum in each group.These results were compared with the results of BD CBA to explore the advantages of BD CBA in the diagnosis of tuberculosis and whether it could be combined with the other two technologies to improve the diagnosis of tuberculosis.Methods:The pulmonary tuberculosis patients and pneumonia patients in the Fifth People’s Hospital of Wuxi,healthy subjects who were selected from the Health Examination Center,and latent tuberculosis infection patients screened by tuberculosis department of hospital from January 2017 to January 2019 were selected as the research groups.Research objects were divided into healthy control group and pneumonia group,latent tuberculosis infection group,and tuberculosis group(bacterial negative tuberculosis and bacterial positive tuberculosis).To detect the concentration of the research groups’ cytokines of IL-2,IL-4,IL-6,IL-10,IFN-γ,TNF-α and IL-17 levels by using BD-Pharmingen Cytometric Bead Array(BD CBA).And the results were statistically analyzed.Meanwhile,to detect the research objects in different research groups by using T-SPOT and to detect the mycobacterium nucleic acid content of sputum in each group by using PCR-Fluorescence Probing.The ROC curves were used to analyze the sensitivity,specificity and critical value of cytokines in each group for pulmonary tuberculosis diagnosis.The results were statistically analyzed.Results:(1)The peripheral blood cytokines IL-2,IL-6,IL-10,IFN-y and TNF-α of latent tuberculosis infection group,bacterial negative tuberculosis group and bacterial positive tuberculosis group were higher than the healthy control group and the pneumonia group.The differences were statistically significant(p<0.001).IL-4 and IL-17 were not statistically different(p>0.05).The IL-2 level in the bacterial negative tuberculosis group was lower than that in the latent tuberculosis infection group,and the difference was statistically significant(p<0.001).IFN-y,TNF-α levels were higher than the latent tuberculosis infection group,the differences were statistically significant(p<0.001).IL-4,IL-6,IL-10,IL-17 were not statistically different(p>0.05).The level of TNF-α in the bacterial negative tuberculosis group was higher than that in the bacterial positive tuberculosis group,the difference was statistically significant(p<0.001).There was no significant difference in IL-2,IL-4,IL-6,IL-10,IFN-y and IL-17(p>0.05).The level of IL-2 in the bacterial positive tuberculosis group was lower than that in the latent tuberculosis infection group(p<0.001).The IFN-y level was higher than the latent tuberculosis infection group and the difference was statistically significant(p<0.001).There was no significant difference in IL-4,IL-6,IL-10,TNF-α and IL-17(p>0.05).(2)By analyzing the ROC curves of pulmonary tuberculosis diagnosis by IL-2,IL-6,IL-10,IFN-y and TNF-α,calculated the optimal cut-off point of pulmonary tuberculosis diagnosis by cytokines.It showed the results that combine diagnosis of pulmonary tuberculosis by cytokines was better than any single diagnosis.In the combine diagnosis,the combine test was positive if any of the five cytokines was positive.The sensitivity of combine diagnosis of pulmonary tuberculosis by cytokines was calculated to be 92.85%.(3)The sensitivity of T-SPOT for pulmonary tuberculosis diagnosis was 75.61%.The sensitivity of PCR-Fluorescence Probing for the sputum tuberculosis nucleic acid test was 70.7%.The sensitivity of CBA method for combine diagnosis of pulmonary tuberculosis was 92.68%.The sensitivity of CBA for detecting tuberculosis was higher than the other methods.Compared with T-SPOT.TB and PCR,the difference was statistically significant(P<0.05).Conclusion:(1)Detecting the peripheral blood cytokines by using BD-Pharmingen Cytometric Bead Array(BD CBA)had high secretion levels in the latent tuberculosis infection group,(2)and tuberculosis group(bacterial negative tuberculosis and bacterial positive tuberculosis).It has good sensitivity and specificity for diagnosis of pulmonary tuberculosis.(3)There were some differences of the secretion levels of cytokines in the latent tuberculosis infection group,bacterial negative tuberculosis group and bacterial positive tuberculosis group.So it can provide reference for the identification of tuberculosis infection,bacterial negative tuberculosis and bacterial positive tuberculosis.(4)Cytometric Bead Array is a highly sensitive diagnostic method for diagnosis of pulmonary tuberculosis.It can provide better effects for the diagnosis of tuberculosis when combined with T-SPOT and sputum tuberculosis nucleic acid test. |
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