Changes in serum acute phase protein levels before and after intensive treatment of AFB smear-positive sputum tuberculosis patients
ZHU Ling
GUO Wu
HE Wenjun
LIU Xiaomei
ZHONG Canye
LU Anjing
Abstract：Objective To investigate the changes in serum acute phase protein levels before and after intensified treatment in patients with pulmonary tuberculosis(PTB)positive for acid fast bacilli(AFB)sputum smear,and the feasibility of using them to monitor treatment response.Methods AFB-positive PTB patients who received treatment at Chongqing University Affiliated Fuling Hospital from March 2021 to March 2023 were recruited into the study.According to the matching principle of 1:1:1 ratio and baseline data,three groups of patients were included:AFB 1+(3-9 AFB+/100 fields of view)group,AFB2+(1-9 AFB+/10 fields of view)group,and AFB 3+(1-9 AFB+/1 field of view)group,with 44 cases in each group.Blood samples were collected from the research subjects before and after 2 months of intensive treatment,and detected by the double antibody sandwich enzyme-linked immunosorbent assay(ELISA)to compare serum levels of α2-macroglobulin(α2-MG),amyloid A-1(SAA-1)and haptoglobin(Hp).Serum C-reactive protein(CRP)was measured using immunoturbidimetry.Results Serum α2-MG,SAA-1,Hp,and CRP levels were highest in the AFB3+group,followed by those in the AFB2+group,and lowest in the AFB1+group,P＜0.05;and most of the patients in the AFB1+group had serum α2-MG,SAA-1,Hp,and CRP levels lower than the median values.After 2 months of intensive treatment,94 patients(71.21%)had negative sputum smears.The most significant decrease in α2-MG was observed in PTB patients in the AFB3+group of PTB patients after treatment(P＜0.05).Most of the patients in AFB1+had their sputum turned negative,and most of the sputum non-transformed patients were concentrated in the AFB2+and AFB3+groups(P＜0.05).The decreases in serum α2-MG,SAA-1,CRP,Hp,and Δα2-MG,ΔSAA-1,ΔCRP,and ΔHp were significantly lower in the sputum-turned group than in the sputum-not-turned group after treatment(P＜0.05).Conclusions This study suggests that changes in serum α2-MG,SAA-1,Hp,and CRP levels can be used as indicators to monitor the response to PTB treatment.After intensive treatment,lower or higher levels of serum α2-MG,SAA-1,Hp,and CRP compared to before treatment may reflect that the patient's sputum smear AFB is more likely to turn negative.
Keywords：pulmonary tuberculosisserum amyloid A1haptoglobinC-reactive proteinα2-macroglobulin
Publication Date：2024-10-28
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：6( 418-423 )