摘要
目的:探讨糖类抗原125(CA125)、神经元烯醇化酶(NSE)、结核感染T细胞斑点试验(T-SPOT.TB)单一或联合检测诊断结核菌阴性肺结核的临床应用价值.方法:选取2019年1月-2020年9月在滨州市中心医院收治的菌阳性肺结核患者179例,菌阴性肺结核患者185例,同时选取非结核性肺部疾病者117例.电化学发光法检测血清CA125和NSE,酶联免疫吸附斑点试验法检测全血T-SPOT.TB在上述各组研究对象中的表达情况.结果:①菌阴组CA125、NSE水平和阳性率分别与非结核组比较,差异有统计学意义(P＜0.05).②CA125、NSE、T-SPOT.TB诊断菌阴性肺结核的灵敏度分别为60.00％、67.57％、80.54％;特异度分别为70.09％、63.25％、82.91％;阳性预测值分别为76.03％、74.40％、88.17％;阴性预测值分别为52.56％、55.22％、72.93％.三者联合检测诊断的灵敏度、特异度、阳性预测值、阴性预测值分别为95.14％、47.86％、74.26％、86.15％.③CA125、NSE以及两者联合诊断菌阴性肺结核的AUC分别为0.629、0.607、0.648.结论:①使用单一方法诊断菌阴性肺结核,T-SPOT.TB检测的诊断效能较高.②联合检测中,三者联合检测的灵敏度和阴性预测值较高,联合检测对菌阴性肺结核的临床诊断价值较大.
Abstract
Objective:To investigate the clinical value of single or combined detection of carbohydrate antigen 125(CA125),neuron enolase(NSE)and T-SPOT test for tuberculosis infection(T-SpoT.TB)in the diagnosis of tubercul-negative tuberculosis.Methods:From January 2019 to September 2020,179 patients with bacteria-positive pulmonary tuberculosis and 185 patients with bacteria-negative pulmonary tuberculosis were selected from Binzhou Central Hospital,and 117 patients with non-tuberculous pulmonary disease were selected.Serum CA125 and NSE were detected by electrochemiluminescence,and whole blood T-SPOT.TB expression was detected by ELISA.Results:①The levels and positive rates of CA125 and NSE in the bacteria negative group were significantly higher than those in the non-tuberculosis group(P＜0.05).②The sensitivity of CA125,NSE and T-SPOT.TB were 60.00％,67.57％and 80.54％,respectively.The specificity was 70.09％,63.25％and 82.91％,respectively.Positive predictive values were 76.03％,74.40％and 88.17％,respectively.The negative predictive values were 52.56％,55.22％and 72.93％,respectively.The sensitivity,specificity,positive predictive value and negative predictive value were 95.14％,47.86％,74.26％and 86.15％,respectively.③The AUC of CA125,NSE and their combined diagnosis of bacterial-negative tuberculosis were 0.629,0.607 and 0.648,respectively.Conclusion:①Using a single method to diagnose bacteria-negative pulmonary tuberculosis,T-SPOT.TB detection has a high diagnostic efficiency.②In the joint detection,the sensitivity and negative predictive value of the three combined detection are higher,and the combined detection has greater clinical diagnostic value for bacteria-negative tuberculosis.
维普
万方数据