结核感染T细胞斑点试验联合血清ADA、SAA、CA125对活动性肺结核诊断及治疗转归的评估价值

Evaluation Value of Tuberculosis Infection T Cell Spot Test Combined with Serum ADA,SAA and CA125 in the Diagnosis and Treatment Outcome of Active Pulmonary Tuberculosis

目的:探讨结核感染T细胞斑点试验(T-SPOT.TB)联合血清腺苷脱氨酶(ADA)、淀粉样蛋白A(SAA)、糖类抗原125(CA125)对活动性肺结核(APTB)诊断及治疗转归的评估价值。方法:选取2021年10月至2022年10月湖南省胸科医院收治的137例APTB患者(APTB组)和80例非APTB患者(对照组),所有APTB患者接受常规抗结核治疗,根据治疗后转归情况分为转归组(92例)和未转归组(45例)。治疗前进行T-SPOT.TB,并检测血清ADA、SAA、CA125水平。受试者工作特征(ROC)曲线分析T-SPOT.TB联合血清ADA、SAA、CA125诊断APTB和预测治疗转归的效能。结果:APTB组T-SPOT.TB阳性率,血清ADA、SAA、CA125水平高于对照组(P<0.05)。未转归组T-SPOT.TB阳性率,血清ADA、SAA、CA125水平高于转归组(P<0.05)。T-SPOT.TB联合血清ADA、SAA、CA125诊断APTB以及预测其治疗转归的曲线下面积(AUC)分别为0.917、0.833,高于单一指标。结论:APTB患者T-SPOT.TB阳性率增加,血清ADA、SAA、CA125水平增高,与抗结核治疗后转归不良有关,T-SPOT.TB联合血清ADA、SAA、CA125在APTB诊断和治疗转归评估中具有较高价值。

Objective:To investigate the evaluation value of tuberculosis infection T cell spot test(T-SPOT.TB)combined with serum adenosine deaminase(ADA),amyloid A(SAA)and carbohydrate antigen 125(CA125)in the diagnosis and treatment outcome of active pulmonary tuberculosis(APTB).Methods:137 APTB patients(APTB group)and 80 non-APTB patients(control group)who were admitted to Hunan Chest Hospital from October 2021 to October 2022 were selected,all APTB patients received routine anti-tuberculosis treatment,patients were divided into outcome group(92 cases)and non-outcome group(45 cases)according to the treatment outcome.T-SPOT.TB was performed,and serum ADA,SAA and CA125 levels were detected before treatment.The efficacy of T-SPOT.TB combined with serum ADA,SAA and CA125 in the diagnosis of APTB and predicting treatment outcome were analyzed by receiver operating characteristic(ROC)curve.Results:The positive rate of T-SPOT.TB and the levels of serum ADA,SAA and CA125 in APTB group were higher than those in control group(P<0.05).The positive rate of T-SPOT.TB and the levels of serum ADA,SAA and CA125 in non-outcome group were higher than those in outcome group(P<0.05).The area under the curve(AUC)of T-SPOT.TB combined with serum ADA,SAA and CA125 in diagnosing APTB and predicting its treatment outcome were 0.917 and 0.833 respectively,which were higher than those of single index.Conclusion:The positive rate of T-SPOT.TB in APTB patients increased,and the levels of serum ADA,SAA and CA125 increased,which were relate to the poor prognosis after anti-tuberculosis treatment,T-SPOT.TB combined with serum ADA,SAA and CA125 had high value in the diagnosis and treatment outcome evaluation of APTB.