الملخص
Objective To explore the clinical application value of combined detection of apolipoprotein A1(ApoA1)and alpha-fetoprotein(AFP)in young and middle-aged patients with pulmonary tuberculosis.Meth-ods A total of 82 young and middle-aged patients with pulmonary tuberculosis admitted to the hospital from December 2020 to December 2021 were selected as the observation group,and 85 healthy people who under-went physical examination in the hospital during the same period were selected as the control group.The clini-cal,lipid,inflammation and iron metabolism related indexes were compared between the two groups.Multiva-riate Logistic regression was used to analyze the influencing factors of pulmonary tuberculosis in young and middle-aged patients.The area under the receiver operating characteristic(ROC)curve(AUC)was used to e-valuate the application value of ApoA1,AFP and their combination in the diagnosis of pulmonary tuberculosis in young and middle-aged patients.Results Compared with the control group,the observation group had sig-nificantly higher levels of direct bilirubin,creatinine,AFP and high-sensitivity C-reactive protein(P<0.05),and significantly lower levels of triglyceride,total cholesterol,high-density lipoprotein cholesterol and ApoA1(P<0.05).Multivariate Logistic regression analysis showed that ApoA1 was an independent protective factor(OR=0.119,95%CI 0.019-0.754,P=0.024)and AFP was an independent risk factor(OR=1.554,95%CI 1.138-2.122,P=0.006)for pulmonary tuberculosis in young and middle-aged patients.ApoA1,AFP and the combined prediction of young and middle-aged tuberculosis AUC were 0.644(P=0.006),0.262(P<0.001),0.678(P=0.001),respectively.Conclusion The low level of ApoA1 is an independent protec-tive factor for pulmonary tuberculosis in young and middle-aged patients,and the high level of AFP is an inde-pendent risk factor for pulmonary tuberculosis in young and middle-aged patients.The combined detection of ApoA1 and AFP has good value in predicting pulmonary tuberculosis in young and middle-aged patients.