摘要
目的 研究痰菌阴性肺结核经验诊断模型的建立价值。方法 回顾性分析2020年5月—2021年5月医院收治的60例初治痰菌阴性肺结核患者病历资料,记作病例组。另取同期医院收治的非结核肺病患者60例作为对照组。分析两组临床特征,并以非条件Logistic回归分析明确痰菌阴肺结核诊断相关因素。以临床诊断结果作为金标准,分析诊断模型应用于痰菌阴肺结核诊断中的效能。结果 咳嗽时长≥2周、咯血、全身结核中毒症状、并发其他疾病、病灶处于单侧或双侧肺上叶尖后段或(和)下叶背段、空洞形成、A/G>1.2、CA-125>35 k U/L、IGRA阳性、血清TB-Ab阳性均是痰菌阴肺结核的独立因素(P<0.05)。以临床诊断结果作为金标准,诊断模型诊断痰菌阴肺结核的灵敏度、特异度及准确度分别为88.33%(53/60)、83.33%(50/60)、85.83%(103/120)。结论 痰菌阴性肺结核经验诊断模型的建立具有成为痰菌阴性肺结核辅助参考工具的潜在价值,可为临床痰菌阴性肺结核的诊断提供可靠依据。
Objective To study the value of empirical diagnosis model of sputum-negative pulmonary tuberculosis.Methods The medical records of 60 sputum-negative pulmonary tuberculosis patients admitted to the hospital from May 2020 to May 2021 were retrospectively analyzed and recorded as case groups.Another 60 patients with non-tuberculosis pulmonary disease admitted to the hospital during the same period were selected as the control group.The clinical characteristics of the two groups were analyzed,and unconditional Logistic regression analysis was used to identify the factors associated with the diagnosis of sputum-negative pulmonary tuberculosis.Used clinical diagnosis results as the gold standard,the efficacy of the diagnostic model in the diagnosis of sputum-negative pulmonary tuberculosis was analyzed.Results Cough duration ≥ 2 weeks,hemoptysis,symptoms of systemic tuberculosis poisoning,complicated with other diseases,lesions located in the posterior segment of unilateral or bilateral upper lobe or(and) dorsal segment of lower lobe,cavity formation,A/G>1.2,CA-125>35 k U/L,IGRA positive and serum TB-Ab positive were all independent factors for sputum-negative pulmonary tuberculosis(P<0.05).Taking the clinical diagnosis results as the gold standard,the sensitivity,specificity and accuracy of the diagnostic model for diagnosing sputum-negative pulmonary tuberculosis were 88.33%(53/60),83.33%(50/60) and 85.83%(103/120),respectively.Conclusion The establishment of an empirical diagnostic model of sputum-negative pulmonary tuberculosis has potential value as an auxiliary reference tool for sputum-negative pulmonary tuberculosis,and can provide a reliable basis for the diagnosis of clinical sputum-negative pulmonary tuberculosis.
作者
吕振梁
赖清谊
陈镇清
LYU Zhenliang;LAI Qingyi;CHEN Zhenqing(Department of Internal Medicine,Heshan People's Hospital,Heshan,Guangdong Province,529700 China)
出处
《系统医学》
2022年第5期99-102,共4页
Systems Medicine
基金
江门市医疗卫生领域科技计划项目(2020020100810003380)。
关键词
肺结核
痰菌阴性
经验诊断模型
诊断效能
Pulmonary tuberculosis
Sputum negative
Empirical diagnostic model
Diagnostic efficacy
