The Role of CD4+ Cells, Monocyte-Lymphocyte Ratio, and Fibrinogen Elevation in the Progression of Focal Lesions in Brucellosis.

Abstract

Background: The focal lesions were the significant clinical challenge for brucellosis, a widespread infectious disease. The aim of this study was to investigate the risk factors for focal lesions in brucellosis, thereby providing support for clinical diagnosis and treatment.

Methods: A total of 339 brucellosis patients were recruited, including 147 patients with focal complications and 192 patients without focal complications. The patient's medical records were reviewed, and laboratory findings were recorded. All the data were analyzed using SPSS 27.0.

Results: Spondylitis (65.99%) was the main focal complication in the 147 brucellosis patients. The percent of CD3+ cells and CD3+ CD4+ cells, the levels of neutrophil, monocyte, platelet-lymphocyte ratio (PLR), neutrophil-lymphocyte ratio (NLR), monocyte-lymphocyte ratio (MLR), IL-6, IL-10, IL-12p70, and FIB (fibrinogen) showed a statistically upward trend, while the absolute counts of CD+ 19 cells, CD16+ CD56+ cells and the percent of CD16+ CD56+ cells were significantly decreased in patients with focal complication (p < 0.05). Percent of CD3+ CD4+ cells (odds ratio [OR]: 1.033, 95% confidence interval [CI]: 1.003-1.063, p = 0.030), MLR (OR: 38.115, 95% CI: 2.396-606.305, p = 0.010), and FIB (OR: 1.363, 95% CI: 1.089-1.705, p = 0.007) were the independent risk factors for focal complications in brucellosis patients in the multivariate logistic regression analysis and the areas under curve (AUC) of receiver operating characteristic for the three factors were 0.576, 0.640, and 0.641, respectively. The AUC for the model including these three indicators was 0.716, and the risk of focal lesions increased almost three times in patients with value above the cutoff value.

Conclusion: CD3+ CD4+ cell percent, MLR and FIB were the independent risk factors for focal lesions in human brucellosis.