艾滋病合并肺结核患者中血清C反应蛋白与结核抗体的临床应用价值分析

Analysis of the clinical application value of serum C-reactive protein and tuberculosis antibody in patients with AIDS complicated with tuberculosis

目的 探讨结核抗体(Tubercle bacillus antibody,TB-Ab)与C反应蛋白(C-reactive protein,CRP)检测在艾滋病合并肺结核患者中的水平变化和临床应用价值。方法 选取2020年7月至2021年7月本院收治的50例艾滋病合并肺结核确诊患者作为观察1组,同期选取单纯肺结核确诊患者50例为观察2组,同时选取体检健康人50例作为对照组;通过收集整理病人的一般资料和血清TB-Ab、CRP的实验室指标结果,比较分析三组结核抗体的阳性率和血清C反应蛋白水平变化。结果 结核抗体检测率,观察2组52.00%(26/50)高于观察1组34%(17/50)高于对照组4.00%(2/50),与观察2组相比,观察1组和对照组均处于较低水平,差异有统计学意义(χ^(2)=24.26,11.09,均P<0.05)。血清CRP检测水平结果显示,观察1组(6534±7.59) mg/L高于观察2组(50.24±8.79) mg/L高于对照组(6.35±1.31) mg/L,与对照组比较,观察1组和观察2组均处于较高水平,差异有统计学意义(t=39.082,24.317,均P<0.05);与观察2组比较,观察1组处于更高水平,差异有统计学意义(t=27.256,P<0.05)。艾滋病合并肺结核患者中单纯TB-Ab检测的灵敏度为34%,特异度为55%;单纯CRP检测的灵敏度为48%,特异度为39%;TB-Ab+CRP联合检测的灵敏度为67%,特异度为59%。结论 临床诊断和治疗艾滋病合并肺结核患者时,采取单一TB-Ab检测敏感度较低,而血清CRP增高的敏感度相对更高,TB-Ab+CRP联合检测的灵敏度和特异度均高于各指标的单独检测,TB-Ab和CRP的联合监测在艾滋病合并肺结核患者的治疗和评估中起重要作用,确保其准确率。

Objective To discus and explore the level change and clinical application value of between tubercle bacillus antibody(TB-Ab)and C-reactive protein(CRP)in HIV patients complicated with tuberculosis.Methods A total of 50 cases of HIV/AIDS patients with tuberculosis admitted to our hospital from July 2020 to July 2022 were selected as observation group 1,50 cases of pure tuberculosis patients were selected as observation group 2,and 50 cases of healthy people were selected as control group,the positive rate of TB antibody and the changes of serum C-reactive protein in the three groups were compared and analyzed by collecting the general data of patients and the laboratory index results of serum TB-Ab and CRP.Results In this study,the positive rate of binding antibody detection in observation group 2 was 52.00%(26/50),it was higher than that in observation group 1,34%(17/50)and 4.00%(2/50)higher than that in control group.Compared with observation group 2,observation group 1 and control group were both at a lower level,and the difference was statistically significant(χ^(2)=24.26,11.09,all P<0.05).The results of serum CRP detection showed that observation group 1(65.34±7.59)was higher than observation group 2(50.24±8.79)and control group(6.35±1.31).Compared with control group 3,observation group 1 and control group2 were both at a higher level,and the difference was statistically significant(t=39.082,24.317,all P<0.05);Compared with observation group 2,observation group 1 was at a higher level,and the difference was statistically significant(t=27.256,P<0.05).The sensitivity and specificity of simple TB-Ab detection in AIDS patients with tuberculosis were 34%and 55%respectively.The sensitivity and specificity of CRP alone were 48% and 39% respectively.The sensitivity and specificity of TB-Ab+CRP were 67% and 59% respectively.Conclusion In the clinical diagnosis and treatment of AIDS patients with tuberculosis, the sensitivity of single TB-Ab test is low, but the sensitivity of serum CRP is relatively higher,The sensitivity and specificity of the combined determination of TB-Ab+CRP were higher than those of the single detection of each index.The serum CRP level of patients is significantly increased.Combined monitoring of TB-Ab and CRP plays an important role in the treatment and evaluation of HIV/AIDS patients with tuberculosis, ensure its accuracy.