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基于QuantiFERON-TB金管内试验的活跃结核病预测风险的诺莫图
Qiang Wang1,2,3, Fengdan Zhu4, Yanjuan Cai1
1Department of Clinical Laboratory, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan, People's Republic of China.
Scientific reports
|July 24, 2023
概括
一种新型纳米图模型,NSMC-ATB,使用干扰素γ释放试验 (IGRA) 结果和临床因素,有效地区分活跃结核病 (ATB) 和非活跃结核病 (IATB). 将其与腺脱氨酶 (ADA) 结合起来,进一步改善了在多叶流液病例中ATB预测.
科学领域:
- 免疫学 免疫学 免疫学
- 传染性疾病 传染性疾病
- 诊断医学 诊断医学 诊断医学
背景情况:
- 干扰素-γ释放试验 (IGRA) 检测结核病感染,但无法区分活性 (ATB) 和非活性 (IATB).
- 准确的区分对于适当的治疗和患者管理至关重要.
- 现有的诊断工具需要改进,以提高预测准确度.
研究的目的:
- 为预测活跃结核病 (ATB) 风险建立一个名谱模型 (NSMC-ATB).
- 使用QuantiFERON-TB Gold In-Tube Test (QFT-GIT) 的结果和临床数据,将ATB与非活性结核病 (IATB) 区分开来.
- 评估NSMC-ATB模型和腺脱氨酶 (ADA) 在ATB患有多叶流血 (PE) 的病例中的联合性能.
主要方法:
- 开发了一种使用逻辑回归在QFT-GIT结果正的培训队列上的名ogram模型.
- 包括变量:性别,年龄,多叶膜溢出 (PE),以及QFT-GIT干扰素-γ (IFN-γ) 度 (尼尔,结核病抗原,基因).
- 在一个单独的队列中验证了该模型,并评估了其与PE的ATB与ADA相结合的性能.
主要成果:
- NSMC-ATB模型显示出良好的诊断性能:AUC为0.819 (培训) 和0.785 (验证).
- 灵敏度和特异性分别为73.16%和75.95% (培训),以及67.44%和75.14% (验证).
- 将NSMC-ATB与ADA结合起来,显著改善了PEATB的预测 (AUC为0.903).
结论:
- 通过NSMC-ATB的纳米图谱模型,可以有效地区分活跃的结核病与非活跃的结核病.
- 该模型为提高结核病诊断准确度提供了有价值的工具.
- NSMC-ATB和ADA的结合提高了ATB病例的诊断性能,而ATB病例的诊断性能则因多溢液而复杂.
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