Abstract：
To explore the potential value of serum glutamate dehydrogenase (GLDH) combined with inflammatory cytokines as diagnostic biomarkers for anti-tuberculosis drug -induced liver injury (ATB-DILI). We collected the residual serum from the patients who met the criteria after liver function tests. We have examined these parameters including GLDH which were determined by enzyme-linked immunosorbent assay and cytokines which were determined by cytokine combination detection kit. Multivariate logistics stepwise forward regression was applied to establish regression models. A total of 138 tuberculosis patients were included in the diagnostic markers study of ATB-DILI, including normal liver function group (n = 108) and ATB-DILI group(n = 30). Serum GLDH, IL-6 and IL-10 levels were significantly increased in the ATB-DILI group. Receiver operating characteristic curve (ROC) curve showed that the area under curve (AUC) of serum GLDH, IL-6 and IL-10 for the diagnosis of ATB-DILI were 0.870, 0.714 and 0.811, respectively. In logistic regression modeling, the AUC of GLDH combined with IL-10 as an ATB-DILI marker is 0.912. Serum IL-6、IL-10 and GLDH levels began to rise preceded the increase in ALT by 7 days, with significant differences in IL-6 compared with 7 days. Serum GLDH, IL-6 and IL-10 levels were correlated with the severity of liver injury. In conclusion, we found that GLDH, IL-6 and IL-10 alone as diagnostic markers of ATB-DILI had good diagnostic efficacy. Logistic regression model established by GLDH and IL-10 had better diagnostic efficacy and IL-6 may be an early predictor of liver injury in the setting of ATB poisoning.
摘要：
探讨血清谷氨酸脱氢酶(GLDH)联合炎性细胞因子作为抗结核药物性肝损伤(ATB-DILI)诊断标志物的潜在价值。我们从肝功能测试后符合标准的患者中收集残留血清。我们已经检查了这些参数，包括通过酶联免疫吸附测定确定的GLDH和通过细胞因子组合检测试剂盒确定的细胞因子。采用多元物流逐步回归建立回归模型。共有138名结核病患者被纳入ATB-DILI的诊断标志物研究，包括肝功能正常组(n=108)和ATB-DILI组(n=30)。血清GLDH,IL-6和IL-10水平在ATB-DILI组中显著增加。受试者工作特征曲线(ROC)曲线显示血清GLDH曲线下面积(AUC),诊断ATB-DILI的IL-6和IL-10分别为0.870、0.714和0.811。在逻辑回归建模中，GLDH与作为ATB-DILI标志物的IL-10组合的AUC为0.912。血清IL-6、IL-10和GLDH水平在ALT升高前7天开始升高,IL-6与7天相比有显著差异。血清GLDH,IL-6和IL-10水平与肝损伤的严重程度相关。总之,我们发现GLDH,IL-6和IL-10单独作为ATB-DILI的诊断标志物具有良好的诊断功效。GLDH和IL-10建立的Logistic回归模型具有较好的诊断效能，IL-6可能是ATB中毒患者肝损伤的早期预测因子。
