尿液特异性抗体检测在不典型肾结核早期诊断中的价值

Value of urine-specific antibody detection in the early diagnosis of atypical renal tuberculosis

目的分析尿液特异性抗体检测用于早期诊断不典型肾结核中的价值。方法选取2021年1月至2023年12月恩施市中心医院和恩施土家族苗族自治州中心医院收治的疑似不典型肾结核总共80例患者为研究对象,采用胶体金法测定尿液内结核分枝杆菌IgG、IgM抗体。以尿液结核分枝杆菌培养及菌型鉴定结果作为金标准,分析尿液特异性结核分枝杆菌IgG、IgM抗体联合检测对不典型肾结核的诊断效能。结果金标准下阳性64例(包含人型结核分枝杆菌63例,牛型结核分枝杆菌1例),阴性16例;尿液特异性结核分枝杆菌IgG联合IgM抗体检测阳性63例,阴性17例。尿液特异性结核分枝杆菌IgG联合IgM抗体检测诊断肾结核的灵敏度为96.88%,特异度为93.75%,约登指数为0.906,阳性预测值为98.41%,阴性预测值为88.24%。结论尿液特异性抗体检测可用于不典型肾结核的早期诊断,尿液特异性结核分枝杆菌IgG联合IgM抗体检测能提高诊断效能。

Objective To analyze the value of urine specific antibody detection in the early diagnosis of atypical renal tuberculosis.Methods A total of 80 patients with suspected atypical renal tuberculosis admitted to Enshi Central Hospital and Enshi Tujia and Miao Autonomous Prefecture Central Hospital from 2021.01 to 2023.12 were selected as the study objects.Urine samples were collected for the determination of urinary tuberculosis IgG and IgM antibodies by colidal gold method,and the results of urine Mycobacterium tuberculosis culture and bacterial type identification were used as the gold standard.To evaluate the diagnostic efficacy of urine specific tuberculosis IgG and IgM antibodies in atypical renal tuberculosis.Results The gold standard showed that 64 cases were positive(including 63 cases of Mycobacterium tuberculosis human and 1 case of Mycobacterium tuberculosis bovis)and 16 cases were negative.Urine specific tuberculosis IgG combined with IgM antibody was positive in 63 cases and negative in 17 cases.The sensitivity,specificity,Joden index,positive predictive value and negative predictive value of urine specific tuberculosis IgG combined with IgM antibody were 96.88%,93.75%,0.906,98.41%and 88.24%respectively.Conclusion Urine specific antibody detection can be used in early diagnosis of atypical renal tuberculosis,and the combined detection of urine specific tuberculosis IgG and IgM antibody can improve the diagnostic efficiency.