摘要
目的:探讨γ-干扰素诱导蛋白-10(interferon gamma-induced protein 10,IP-10) mRNA检测技术对不同年龄组结核病患者的辅助诊断价值。方法:前瞻性纳入2018年3月至2022年7月在首都医科大学附属北京胸科医院、河南省传染病医院和深圳市第三人民医院收治、且完成IP-10 mRNA检测的疑似结核病患者1590例。剔除诊断不明确200例,共1390例纳入分析。根据诊断结果分为确诊结核病组(475例)、临床诊断结核病组(518例)、非结核病组(397例)。按照年龄将入组患者分为中青年组(18~59岁)1062例和老年组(60~95岁)328例。在不同年龄组中,以临床诊断结果为标准,分析IP-10 mRNA检测对结核病的诊断效能。结果:中青年组IP-10 mRNA检测的敏感度和特异度分别为90.2%(721/799,95%CI:87.9%~92.1%)和68.8%(170/247, 95%CI:62.6%~74.4%),老年组IP-10 mRNA检测的敏感度和特异度分别为87.8%(159/181,95%CI:82.0%~92.0%)和54.7%(76/139,95%CI:46.0%~63.1%)。两个年龄组间IP-10 mRNA检测的敏感度比较差异无统计学意义(χ^(2)=0.922,P=0.337),但中青年组IP-10 mRNA检测的特异度高于老年组,差异有统计学意义(χ^(2)=7.704,P=0.006)。随年龄增长,IP-10 mRNA检测的敏感度的变化差异无统计学意义(Z=-1.063,P=0.288),特异度随年龄增长明显降低(Z=-2.846,P=0.004)。结论:IP-10 mRNA检测对中青年结核病患者的辅助诊断更有价值;考虑IP-10 mRNA检测的敏感度受年龄影响较小,可能有助于在老年人群中应用该技术进行结核感染的主动筛查。
Objective:To evaluate the auxiliary value of interferon gamma-induced protein 10(IP-10)mRNA release assay in the diagnosis for tuberculosis in different age groups.Methods:Totally 1590 suspected tuberculosis patients who were admitted to the Beijing Chest Hospital,Henan Infectious Diseases Hospital,and the Third People’s Hospital of Shenzhen from March 2018 to July 2022 and who finished IP-10 mRNA release assay before anti-tuberculosis therapy were prospectively recruited.A total of 1390 cases were included in the final analysis,and were divided into definite TB group(n=475),probable TB group(n=518)and non-TB group(n=397),according to the clinical diagnosis results.Other 200 cases with unclear diagnosis were excluded from the analysis.Furthermore,all the patients included in the analysis were further divided into two groups according to the age,the younger group(n=1062,18-59 years)and the elderly group(n=328,60-95 years).The diagnostic performance of IP-10 mRNA release assay were analyzed in the different age groups,based on the final diagnosis in clinic.Results:The sensitivity and specificity of IP-10 mRNA release assay were 90.2%(721/799,95%CI:87.9%-92.1%)and 68.8%(170/247,95%CI:62.6%-74.4%),respectively in the younger group,while 87.8%(159/181,95%CI:82.0%-92.0%)and 54.7%(76/139,95%CI:46.0%-63.1%),respectively in the elderly group.The specificity of IP-10 mRNA release assay in the younger group was significantly higher than that in the elderly group(χ^(2)=7.704,P=0.006).However,there were no significant difference in the sensitivity between the two groups(χ^(2)=0.922,P=0.337).There was no significant difference in the trend of diagnostic sensitivity of IP-10 mRNA release assay with the increasing age(Z=-1.063,P=0.288),but the diagnostic specificity was decreased significantly with the increasing age(Z=-2.846,P=0.004).Conclusion:IP-10 mRNA release assay is a promising test for auxiliary diagnosis of tuberculosis in younger patients;while considering the less impact of age on diagnostic sensitivity of IP-10 m
作者
宋瑞雪
董静
姚明旭
贾红彦
李自慧
孙琦
朱传智
杜博平
邢爱英
潘丽萍
Song Ruixue;Dong Jing;Yao Mingxu;Jia Hongyan;Li Zihui;Sun Qi;Zhu Chuanzhi;Du Boping;Xing Aiying;Pan Liping(Beijing Key Laboratory for Drug Resistant Tuberculosis Research/Beijing Chest Hospital,Capital Medical University/Beijing Tuberculosis and Thoracic Tumor Research Institute,Beijing 101149,China)
出处
《中国防痨杂志》
CAS
CSCD
北大核心
2024年第2期221-227,共7页
Chinese Journal of Antituberculosis
基金
北京市自然科学基金(7212012,L234055)
通州区科技计划项目(KJ2022CX042)
北京市医院管理中心青年职工创新工作室-创新梦工场(202136)
国家自然科学基金(82172279,82070012)
通州区运河计划人才项目(YH201807,YH202001)。
关键词
结核
诊断
鉴别
干扰素类
干扰素诱导剂
Tuberculosis
Diagnosis
differential
Interferons
Interferon inducers
