煤矿工人尘肺合并结核患者早期诊断的临床评价  

Clinical evaluation of early diagnosis of coal worker's pneumoconiosis complicated with tuberculosis

作　　者：邵青 SHAO Qing

机构地区：[1]徐州医科大学第二附属医院/徐州矿务集团总医院,江苏省徐州市221006

出　　处：《中国研究型医院》2020年第4期20-23,共4页Chinese Research Hospitals

摘　　要：目的:探讨煤工尘肺合并结核早期诊断的临床评价。方法:采用回顾性研究模型,收集2017年6月~2019年6月于徐州矿务集团总医院尘肺科住院确诊的煤工尘肺患者149例为研究对象,分为尘肺合并早期结核感染组71例、单纯尘肺组78例,同期本院初诊单纯早期肺结核患者共60例为结核感染组。所有入组成员均进行结核分枝杆菌干扰素-γ释放试验(TB-IGRA)、结核分歧杆菌脱氧核糖核酸(TB-DNA)和干扰素-γ(INF-γ)等相关实验室检测,收集相关实验数据进行统计分析。结果:TB-IGRA在尘肺合并早期结核组和结核组的阳性检出率分别为94.4%和93.3%,两者比较差异无统计学意义(P>0.05);TB-DNA在尘肺合并早期结核组和结核组的阳性检出率分别为91.5%和96.7%,两者比较差异无统计学意义(P>0.05);IFN-γ在尘肺合并早期结核组和结核组的水平均高于尘肺组,且差异有统计学意义(P<0.05),尘肺合并早期结核组的IFN-γ水平高于早期结核组,且差异有统计学意义(P<0.05)。TB-IGRA指标诊断尘肺患者合并早期结核的敏感度为94.4%,高于其他单一指标。受试者工作特征(ROC)曲线分析显示,三者联合检测的敏感度(95.8%)、特异度(100%)和曲线下面积[(AUC),为0.983]均高于单一指标。结论:TB-IGRA、TB-DNA和IFN-γ联合诊断对煤工尘肺合并结核具有较高的早期诊断价值,可用于尘肺患者结核早期筛查、早期诊断。Objective:Discussion on clinical evaluation of early diagnosis of coal worker's pneumoconiosis complicated with tuberculosis.Methods:A retrospective study model was used to collect 149 cases of coal worker's pneumoconiosis diagnosed in the pneumoconiosis department of Xuzhou Mining Group General Hospital from June 2017 to June 2019.The study was divided into 71 cases of pneumoconiosis combined with early tuberculosis infection.In the simple pneumoconiosis group,78 patients were diagnosed with tuberculosis infection in 60 patients with early pulmonary tuberculosis.All incoming members were tested in laboratories related to Mycobacterium tuberculosis interferongamma release test(TB-IGRA),binding Bacillus deoxyribonucleic acid(TB-DNA)and interferon-gamma(INF-γ),Collect relevant experimental data for statistical analysis.Results:The positive detection rates of TB-IGRA in the early stage of pneumoconiosis combined with tuberculosis and tuberculosis were 94.4%and 93.3%,respectively,and the difference was not statistically significant(P>0.05);TB-DNA in pneumoconiosis combined with early tuberculosis group and tuberculosis The positive detection rates of the group were 91.5%and 96.7%,respectively.There was no significant difference between the two groups(P>0.05).The level of IFN-γin the pneumoconiosis combined with the early tuberculosis group and tuberculosis group was higher than that of the pneumoconiosis group,and the difference was Statistically significant(P<0.05),the level of IFN-γin the pneumoconiosis group with early tuberculosis was higher than that in the early tuberculosis group,and the difference was statistically significant(P<0.05).The sensitivity of the TBIGRA index for the diagnosis of pneumoconiosis patients with early tuberculosis was 94.4%,higher than the other single indicators.The receiver operating characteristic curve(ROC)curve analysis showed that the sensitivity(95.8%),specificity(100%)and offline area(AUC=0.983)of the combined detection were higher than the single index.Conclusion:The combin

关 键 词：尘肺 煤 干扰素Γ 结核菌素试验 

分 类 号：R135.2[医药卫生—劳动卫生] R52[医药卫生—公共卫生与预防医学]