血清GM-CSF、sTREM-1联合T-SPOT.TB鉴别诊断肺结核的价值  

Roles of serum GM-CSF,sTREM-1 combined with T-SPOT.TB in the differential diagnosis of pulmonary tuberculosis

作　　者：李点 郑正 江叶舟 LI Dian;ZHENG Zheng;JIANG Yezhou(Department of General,Hunan Chest Hospital,Changsha 410003,Hunan,China)

机构地区：[1]湖南省胸科医院综合科,湖南长沙410003

出　　处：《检验医学》2021年第8期833-836,共4页Laboratory Medicine

摘　　要：目的探讨血清粒细胞巨噬细胞集落刺激因子(GM-CSF)、可溶性髓系细胞触发受体-1(sTREM-1)联合结核感染T细胞斑点试验(T-SPOT.TB)鉴别诊断肺结核的价值。方法选取肺结核患者94例(肺结核组),以其他肺部疾病患者94例作为对照组。检测所有对象血清GM-CSF、sTREM-1水平,同时进行T-SPOT.TB。采用Logistic回归分析建立血清GM-CSF、sTREM-1和T-SPOT.TB联合检测定性诊断肺结核的方程。采用受试者工作特征(ROC)曲线评估各项指标鉴别诊断肺结核的价值。结果肺结核组血清GMCSF、sTREM-1水平均显著高于对照组(P=0.000)。ROC曲线分析结果显示,以痰涂片或培养结果为标准,GM-CSF、sTREM-1、T-SPOT.TB单项检测及联合检测鉴别诊断肺结核的曲线下面积(AUC)分别为0.674、0.687、0.758、0.832。3项指标联合检测诊断肺结核的效能优于单项检测(P<0.05)。结论GM-CSF、sTREM-1联合T-SPOT.TB可有效提高肺结核的诊断效能。Objective To investigate the roles of serum granulocyte macrophage colony stimulating factor(GM-CSF),soluble triggering receptor expressed on myeloid cell-1(sTREM-1)combined with T-cell spot test for tuberculosis infection(T-SPOT.TB)in the differential diagnosis of pulmonary tuberculosis.Methods A total of 94 patients with pulmonary tuberculosis were enrolled as observation group,and 94 patients with other lung diseases were enrolled as control group.Serum GM-CSF and sTREM-1 levels were determined,and T-SPOT.TB was performed simultaneously.Logistic regression analysis was used to establish the equation of GM-CSF,sTREM-1 and T-SPOT.TB combined determination for the diagnosis of pulmonary tuberculosis.The diagnostic efficiency of GM-CSF,sTREM-1 and T-SPOT.TB in the diagnosis of pulmonary tuberculosis was evaluated by receiver operating characteristic(ROC)curve.Results The levels of GM-CSF and sTREM-1 in observation group were higher than those in control group(P=0.000).Taking sputum smear or culture test results as standard,the areas under curves(AUC)of GM-CSF,sTREM-1,T-SPOT.TB single determinations and combined determination for the diagnosis of pulmonary tuberculosis were 0.674,0.687,0.758 and 0.832,respectively.The combined determination of the 3 indicators was more effective than single determinations in diagnosing pulmonary tuberculosis(P<0.05).Conclusions GM-CSF,sTREM-1 combined determination with T-SPOT.TB can effectively improve the diagnostic efficiency of pulmonary tuberculosis.

关 键 词：粒细胞巨噬细胞集落刺激因子 可溶性髓系细胞触发受体-1 结核感染T细胞斑点试验 肺结核 

分 类 号：R446.1[医药卫生—诊断学]