摘要
目的探索血浆血小板源生长因子(PDGF-BB)和γ干扰素诱导蛋白10(IP-10)在活动性肺结核患者外周血中的水平及其诊断价值。方法选取2016年2月-2018年2月我院收治的活动性肺结核患者104例为研究组,同时选取我院其他肺部疾病患者50例为对照组,采集所有患者的外周血取上清测定PDGF-BB与IP-10水平。利用ROC曲线分析PDGF-BB与IP-10对活动性肺结核的诊断效能,并与结核感染T细胞斑点试验(T-SPOT.TB)对比,分析联合诊断在活动性肺结核筛查中的价值。结果研究组血清PDGF-BB和IP-10水平显著高于对照组(P<0.05);血清PDGF-BB、IP-10联合检测诊断活动性肺结核灵敏度、特异度分别为88.46%、52.00%,联合检测约登指数(0.405)高于单项检测(0.195、0.372),但低于T-SPOT.TB(0.606);PDGF-BB、IP-10联合检测活动性肺结核ROC曲线下面积(0.828)明显高于PDGF-BB、IP-10单独检测(0.630、0.664)。联合检测的特异度低于T-SPOT.TB(76.00%)(χ2=6.25,P=0.012),但灵敏度、准确度等与T-SPOT.TB比较无统计学差异(χ2=0.66,P=0.416;χ2=1.26,P=0.261),同时,联合检测的ROC曲线下面积高于T-SPOT.TB(0.746)(P<0.05)。结论PDGF-BB和IP-10在活动性肺结核患者血中水平增高;PDGF-BB和IP-10联合检测对活动性肺结核诊断效能与T-SPOT.TB相近,可应用于临床筛查。
Objective To explore the clinical value of combined detection of platelet-derived growth factor and interferon-inducible protein-10 in peripheral blood of patients with active tuberculosis.Methods 104 patients with active tuberculosis from February 2016 to February 2018 were selected as the research group.At the same time,50 cases with non TB pulmonary disease in our hospital were selected as the control group.Peripheral blood samples from all patients were collected to determine the levels of PDGF-BB and IP-10.It used ROC curve to analyze the diagnostic efficiency of PDGF-BB and IP-10 for single diagnosis and combined diagnosis.The value of combined diagnosis in screening for active pulmonary tuberculosis was compared with T-SPOT.TB.Results The serum levels of PDGF-BB and IP-10 were significantly higher in the research group than in the control group(P<0.05).The sensitivity,specificity,accuracy,positive predictive value and negative positive predictive value of combining with serum PDGF-BB and IP-10 were 88.46%,52.00%,76.62%,79.31%and 64.42%.The combined test of the Jordan index(0.405)was higher than the individual test(0.195,0.372),but it was lower than T-SPOT.TB(0.606).The area under the ROC curve of PDGF-BB combined with IP-10(0.828)was significantly higher than that of PDGF-BB and IP-10 alone(0.630,0.664)(P<0.05).The specificity of combined detection was lower than that of T-SPOT.TB alone(76.00%)(χ2=6.25,P=0.012).However,there was no statistical difference in sensitivity and accuracy(χ2=0.66,P=0.416;χ2=1.26,P=0.261).At the same time,the area under ROC curve of joint detection was higher than that of T-SPOT.TB(0.746)(P<0.05).Conclusion PDGF-BB and IP-10 have high expression in active tuberculosis patients.The combination of PDGF-BB,IP-10 and T-SPOT.TB can improve the sensitivity and accuracy in detecting active pulmonary tuberculosis.PDGF-BB combine with IP-10 shows similar diagnosis value on active pulmonary tuberculosis,which is suitable for clinical screening.
作者
李志鹏
LI Zhi-peng(Clinical Laboratory,Navy Anqing Hospital of PLA,Anqing,Anhui 246000,China)
出处
《临床肺科杂志》
2019年第11期2000-2003,2019,共5页
Journal of Clinical Pulmonary Medicine
基金
2017年度院级立项课题(No HY2017009)
