摘要
目的探讨γ干扰素释放试验在广州地区艾滋病合并疑似结核感染人群中的诊断价值。方法以2015年7月至2016年1月于广州市第八人民医院就诊的252例艾滋病患者为研究对象,根据临床表现、辅助检查等将其分成三组:确诊结核组(n=24)、可疑结核组(n=70)、非结核组(n=158);应用TSPOT.TB试剂盒检测各组患者外周血γ干扰素水平;利用SPSS 13.0统计软件分析检测结果。结果γ干扰素释放试验试剂TSPOT.TB诊断艾滋病合并结核的敏感性为56.38%,特异性为92.40%;在诊断HIV合并肺结核时,TSPOT.TB诊断的敏感性显著低于诊断HIV合并肺外结核(45.54%vs.71.80%,P=0.011),而特异性显著高于诊断HIV合并肺外结核(98.78%vs.84.21%,P=0.003);活动性结核组CD4^+T细胞计数≥200/μL及<200/μL的患者中TSPOT.TB检测阳性率分别为60.0%和58.0%,但差异无统计学意义。绘制TSPOT.TB试验对艾滋病合并疑似结核的诊断价值ROC曲线,曲体下面积为0.744(95%CI:0.676~0.812)。结论 TSPOT.TB试验在广州地区艾滋病合并疑似结核感染人群中有一定的辅助诊断价值。
Objective To evaluate the application of TSPOT.TB in diagnosis of tuberculosis in human immunodeficiency virus（HIV）infected patients in Guangzhou. Methods A total of 252 patients with suspected ATB were evaluated with TSPOT.TB. They were classified into the following three groups according to their diagnosis：24 patients with confirmed TB;70 patients with possible TB;158 patients with no TB. The sensitivity,specificity,positive predictive value（PPV）and negative predictive value（NPV）were calculated to evaluated the TSPOT.TB assay. All data were analyzed with SPSS 13.0.Results The sensitivity of the TSPOT.TB was 56.38% and the specificity was 92.40% in suspected TB in HIV infected patients. The sensitivity obtained from pulmonary tuberculosis in HIV infected patients was significantly lower than extrapulmonary tuberculosis in HIV infected patients（45.54% vs. 71.80%,P=0.011）,while the specificity was higher（98.78%vs. 84.21%,P=0.003）. The positive rate of TSPOT.TB was 60.0% in the patients with CD4-＋T counts no less than 200/μL in the observation group,58.0% in the patients with CD4-＋T counts less than 200/μL,and there was no statistically significant difference.Receiver operating characteristic（ROC） curve of evaluating the application of TSPOT.TB in diagnosing tuberculosis in HIV infected patients was drawn, and the area under the curve was 0.744（95%CI：0.676-0.812）. Conclusion TSPOT.TB assay could be a useful tool in rapid diagnosis of suspected tuberculosis infection in HIV infected individuals.
作者
高鸣
李丽雅
邓西子
唐漾波
陈伟烈
胡凤玉
GAO Ming LI Li-ya DENG Xi-zi TANG Yang-bo CHEN Wei-lie HU Feng-yu(Institute of Infectious Disease, Guangzhou Eighth People＇s Hospital, Guangzhou Medical University, Guangzhou, Guangdong 510060, China)
出处
《热带医学杂志》
CAS
2017年第9期1137-1140,1159,共5页
Journal of Tropical Medicine
基金
国家感染病临床重点专科资助项目
广州市科信局科技惠民专项(2014Y2-00149)
关键词
艾滋病
结核分枝杆菌
Γ干扰素释放试验
Acquired immunodeficiency syndrome
Mycobacterium tuberculosis
IFN-γ release assay
