The differential value of CD4+/CD8+ratio combined with cytokines in active and inactive pulmonary tuberculosis

Tian Erpeng; Ma Weili; Liu Mei; Qi Yanan

doi:10.3760/j.issn.1673-4777.2024.10.006

Abstract：Objective To discuss the differential value of CD4+/CD8+ratio combined with cytokines in active and inactive pulmonary tuberculosis.Methods Totally 107 patients with pulmonary tuberculosis treated in Hebei Chest Hospital from January 2021 to August 2023 were selected as research objects.They were divided into inactive pulmonary tuberculosis group(53 cases)and active pulmonary tuberculosis group(54 cases)according to the condition.The levels of serum cytokines and CD4+/CD8+ratio were compared between the two groups.The relationship between serum cytokine level and CD4+/CD8+ratio in patients with pulmonary tuberculosis was analyzed by stratified regression analysis.Multivariate Logistic regression analysis was used to analyze the factors affecting the occurrence of active pulmonary tuberculosis.The effect of the interaction between serum cytokines and CD4+/CD8+ratio on the occurrence of active pulmonary tuberculosis was analyzed.The receiver operating characteristic(ROC)curve was used to evaluate the value of serum cytokines and CD4+/CD8+ratio alone and in combination in the differential diagnosis of active and inactive pulmonary tuberculosis.Results The levels of serum interleukin-6(IL-6),interferon-γ(INF-γ),IL-8 and CD4+/CD8+ratio in active pulmonary tuberculosis group were significantly higher than those in inactive pulmonary tuberculosis group(all P＜0.05).The results of stratified regression analysis showed that IL-6,INF-y and IL-8 all had significant positive effects on CD4+/CD8+ratio(all P＜0.05).The results of multivariate Logistic regression analysis showed that the increased levels of serum IL-6,INF-γ,IL-8 and CD4+/CD8+ratio were the risk factors of active pulmonary tuberculosis(all P＜0.05).The results of interaction analysis showed that there was no multiplicative or additive interaction between serum IL-6,INF-γ,IL-8 and CD4+/CD8+ratio before and after adjusting sex and age(all P＞0.05).The areas under the ROC curve of IL-6,INF-γ,IL-8,CD4+/CD8+ratio and their combination were 0.746,0.771,0.805,0.707 and 0.850,respectively,the combination of the four has the highest efficacy in distinguishing active and inactive pulmonary tuberculosis.Conclusion The levels of serum IL-6,INF-γ,IL-8 and peripheral blood CD4+/CD8+ratio in patients with active pulmonary tuberculosis were higher than those in patients with inactive pulmonary tuberculosis.The level of serum cytokines can affect the cellular immunity of patients with pulmonary tuberculosis,based on this,active and inactive pulmonary tuberculosis can be distinguished.