ROC曲线评价多指标对肺结核的诊断价值  

Diagnostic value of various detections in pulmonary tuberculosis as evaluated by ROC curve

作　　者：宋磊 宋梅梅[1] 苏旭 李怡君 李太顺 Song Lei;Song Meimei;Su Xu;Li Yijun;Li Taishun(Department of Tuberculosis,Nanjing Chest Hospital,Nanjing 210000,Jiangsu,China)

机构地区：[1]南京市胸科医院结核科,210000

出　　处：《中华生物医学工程杂志》2017年第5期414-418,共5页Chinese Journal of Biomedical Engineering

基　　金：南京市医学科技发展项目（YKK15169）

摘　　要：目的了解江苏省南京市结核病的发病情况，通过多种诊断方法之间ROC曲线下的面积比较确定多项指标联合检测对肺结核的诊断价值。方法回顾性分析2015年6月至12月间南京市胸科医院门诊和住院的肺结核患者以及需要与肺结核相鉴别的其他肺部疾病患者的临床资料共619例，通过ROC曲线下的面积（AUC）对结核分枝杆菌抗体和结核分枝杆菌感染T细胞斑点试验等指标联合检测肺结核的诊断价值进行评价。结果619例研究对象中，确诊结核患者共519人。ROC曲线结果显示，IgG、LAM、38kd抗体对应的AUC分别为0．591、0．645、0．665，而根据T—SPOT．TB抗原A、B孔有无反应性做出的AUC为0．711。两者联合检测后，对应的AUC为0．774。结论T—SPOT．TB检测技术和结核分枝杆菌抗体检测两种指标联合应用时在肺结核诊断过程中诊断价值更高。Objective To understand the incidence of tuberculosis in Nanjing, Jiangsu Province, and to determine the diagnostic value of combined detection in pulmonary tuberculosis （PTB） by comparing the area under ROC curve （AUC）. Methods The clinical data of 619 subjects from clinics or wards of Nanjing Chest Hospital between June and December, 2015, including PTB patients and those with other pulmonary diseases necessitating differential diagnosis against PTB were retrospectively analyzed. The diagnostic value of combined detections for Myeobacterium tuberculosis （MTB） antibodies and MT-infeeted T cell spot test was evaluated by AUC. Results A total of 519 confirmed PT eases were found among the 619 subjects. The ROC curves showed that AUCs corresponding to test for IgG, LAM and 38kd antibodies were 0.591, 0.645 and 0.665, respectively. The AUC was 0.711 based on the reactivity of T-SPOT.TB antigens A and B. Combined detection of MTB antibodies and spot test yielded an AUC of 0.774. Conclusion Combination of T-SPOT.TB spot test and MTB antibodies may be more valuable in diagnosis of pulmonary tuberculosis than either is used alone.

关 键 词：结核 肺 诊断 

分 类 号：R45[医药卫生—治疗学]