应用ROC曲线分析超敏C反应蛋白对肺结核活动性的诊断效能

Evaluation of the diagnostic efficacy of hypersensitive C-reactive protein for tuberculosis activity by ROC curve

目的分析超敏C反应蛋白(hypersensitivity C-reactive protein,hs-CRP)在活动性肺结核诊断中的作用。方法纳入菌阳肺结核310例、菌阴肺结核196例和非活动性肺结核48例,采集患者EDTA-K;抗凝静脉血2 ml,采用双抗体夹心法定量检测hs-CRP含量,应用ROC曲线分析hs-CRP对活动性肺结核诊断的价值。结果菌阳性肺结核组和菌阴性肺结核组hs-CRP含量均高于非活动性肺结核组(Z值分别为4.51、2.67,P值均<0.05);ROC曲线分析hs-CRP判断菌阳肺结核和菌阴肺结核活动性的最佳临界值分别为2.80 mg/L和1.40 mg/L。菌阳肺结核组的ROC曲线下面积(AUC)为0.816,菌阴肺结核组的AUC为0.764,且均有统计学意义(P值均<0.05)。结论 hs-CRP可作为活动性肺结核辅助诊断的指标。

Objective To evaluate the diagnostic efficacy of hypersensitive C-reactive protein(hs-CRP) for tuberculosis activity by receiver operating characteristic curve(ROC curve). Methods A total of 310 cases of bacterial positive pulmonary tuberculosis, 196 cases of bacterial negative pulmonary tuberculosis and 48 cases of inactive pulmonary tuberculosis were included in the study, who were subjected to 2 ml EDTA-K2 anticoagulant venous blood collection for hs-CRP analysis by double antibody sandwich method, and ROC curve was used to analyze the value of hs-CRP in the diagnosis of tuberculosis activity. Results The hs-CRP content in bacterial positive or negative pulmonary tuberculosis groups were significantly higher than that in inactive pulmonary tubercalosis group(Z=4.51,2.67,all P<0.05).ROC curve analysis showed that the optimal cut-off values of hs-CRP were 2.80 mg/L and 1.40 mg/L for bacterial positive or negative pulmonary tuberculosis diagnosis, and the areas under the ROC curves were 0.816 and 0.764,respectively, the difference was statistically significant(all P<0.05). Conclusion The hs-CRP can be used as an indicator for the auxiliary diagnosis of tuberculosis activity.