| 李志兰,陆志成,郭乃华,雷 昕,付佑辉,何成山.结核感染T细胞斑点试验联合血清CA125、IP-10对肺结核合并糖尿病的诊断价值[J].,2024,(11):2140-2144 |
| 结核感染T细胞斑点试验联合血清CA125、IP-10对肺结核合并糖尿病的诊断价值 |
| Diagnostic Value of Tuberculosis Infection T Cell Spot Test Combined with Serum CA125 and IP-10 in Pulmonary Tuberculosis with Diabetes Mellitus |
| 投稿时间：2023-11-06 修订日期：2023-11-30 |
| DOI：10.13241/j.cnki.pmb.2024.11.026 |
| 中文关键词: 肺结核 糖尿病 结核感染T细胞斑点试验 CA125 IP-10 诊断价值 |
| 英文关键词: Pulmonary tuberculosis Diabetes mellitus Tuberculosis infection T cell spot test CA125 IP-10 Diagnostic value |
| 基金项目:上海市浦东新区卫生健康委员会学科建设计划项目（PWGw2020-02）；上海市卫生健康委员会科研计划项目（202040165） |
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| 中文摘要: |
| 摘要 目的：探讨结核感染T细胞斑点试验（T-SPOT.TB）联合血清糖类抗原125（CA125）、γ干扰素诱导蛋白10（IP-10）对肺结核合并糖尿病的诊断价值。方法：选取2021年1月～2023年1月上海中医药大学附属第七人民医院收治的480例疑似肺结核患者，根据诊断结果分为A组（肺结核合并糖尿病患者）166例、B组（单纯肺结核患者）214例、C组（非结核分枝杆菌感染和非糖尿病患者）100例。所有研究对象均进行T-SPOT.TB，并采用酶联免疫吸附法检测血清CA125、IP-10水平。通过绘制受试者工作特征（ROC）曲线分析T-SPOT.TB联合血清CA125、IP-10水平对肺结核合并糖尿病的诊断价值。结果：A组T-SPOT.TB阳性率低于B组，但高于C组，B组T-SPOT.TB阳性率高于C组（P＜0.05）；A组抗原培养滤液蛋白10（CFP10）、早期分泌性抗原靶蛋白6-kD（ESAT-6）原值高于B组、C组，B组抗原CFP10、抗原ESAT-6原值高于C组（P＜0.05）。A组血清CA125、IP-10水平高于B组和C，B组血清CA125、IP-10水平高于C组（P＜0.05）。ROC曲线分析显示，T-SPOT.TB、CA125、IP-10、T-SPOT.TB+CA125、T-SPOT.TB+IP-10、三项联合诊断肺结核合并糖尿病的曲线下面积（AUC）分别为0.771、0.769、0.779、0.880、0.885、0.937；三项联合诊断肺结核合并糖尿病的AUC大于T-SPOT.TB、CA125、IP-10单独和联合诊断。结论：肺结核合并糖尿病患者T-SPOT.TB阳性率和血清CA125、IP-10水平升高，T-SPOT.TB联合血清CA125、IP-10能提升肺结核合并糖尿病的诊断价值。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the diagnostic value of tuberculosis infection T cell spot test (T-SPOT.TB) combine with serum carbohydrate antigen 125 (CA125) and gamma interferon-inducible protein 10 (IP-10) in pulmonary tuberculosis with diabetes. Methods: 480 patients with suspected tuberculosis admitted to Seventh People's Hospital of Shanghai University of Traditional Chinese Medicine from January 2021 to January 2023 were selected and divided into 166 cases in Group A (patients with tuberculosis combined with diabetes mellitus), 214 cases in Group B (patients with simple tuberculosis), and 100 cases in Group C (patients with non-tuberculous mycobacterial infection and non-diabetes mellitus) according to the diagnosis results. All subjects underwent T-SPOT.TB, and serum CA125 and IP-10 levels were detected by enzyme-linked immunosorbent assay. The diagnostic value of T-SPOT.TB combined with serum CA125 and IP-10 levels for pulmonary tuberculosis with diabetes was analyzed by drawing receiver operating characteristic (ROC) curve. Results: The positive rate of T-SPOT.TB in group A was lower than that in group B but higher than that in group C, and the positive rate of T-SPOT. TB in group B was higher than that in group C (P＜0.05). The original values of group A antigen culture filtrate protein 10 (CFP10) and antigen 6kD early secretory antigenic target (ESAT-6) were higher than those in group B and C, and the original values of group B antigen CFP10 and antigen ESAT-6 were higher than those in group C (P＜0.05). Serum CA125 and IP-10 levels were higher in group A than in groups B and C, the serum CA125 and IP-10 levels in group B were higher than those in group C(P＜0.05). ROC curve analysis showed that, the area under the curve (AUC) of T-SPOT.TB, CA125, IP-10, T-SPOT.TB+CA125, T-SPOT.TB+IP-10 and three-term combination in the diagnosis of pulmonary tuberculosis with diabetes mellitus were 0.771, 0.769, 0.779, 0.880, 0.885 and 0.937 respectively; the AUC of three-term combination diagnosis of pulmonary tuberculosis with diabetes mellitus was greater than that of T-SPOT.TB, CA125, IP-10 alone and combination diagnosis. Conclusion: The positive rate of T-SPOT.TB and the levels of serum CA125 and IP-10 increased in patients with pulmonary tuberculosis with diabetes mellitus, T-SPOT.TB combined with serum CA125 and IP-10 could improve the diagnostic value of pulmonary tuberculosis with diabetes mellitus. |
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