评估分层T-SPOT.TB结果,以提高结核病的诊断准确性:一项具有敏感性,特异性和预测值的回顾性队列研究
Ole Skouvig Pedersen1, Søren Sperling2, Anders Koch3
1Department of Respiratory Diseases and Allergy, Aarhus University Hospital, Aarhus, Denmark; Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.
概括
较高的T-SPOT.TB测试值与增加的结核病 (TBD) 风险相关,特别是边界和阳性结果. 风险高原在十个斑点后,表明事件和流行TBD的强烈关联.
科学领域:
- 免疫诊断 免疫诊断 免疫诊断 免疫诊断
- 传染病流行病学 传染病流行病学
- 公共卫生 公共卫生
背景情况:
- T-SPOT.TB是一种用于检测Mycobacterium结核病感染的干扰素-玛释放试验.
- 了解T-SPOT.TB结果与结核病 (TBD) 风险之间的定量关系对于风险分层至关重要.
- 以前的研究主要集中在定性T-SPOT.TB结果上,不太重视定量值及其与事件和流行TBD的关联.
研究的目的:
- 调查定量T-SPOT.TB点位计数与发生和流行结核病 (TBD) 风险之间的关联.
- 为了确定与TBD相关的风险因素,在与T-SPOT.TB.TB测试的个体中.
- 评估T-SPOT.TB的诊断准确性,以确定发生和流行的TBD.
主要方法:
- 在2010年至2017年期间对T-SPOT.TB进行测试的患者进行了回顾性队列研究.
- 在2022年之前对事件TBD的随访,从患者记录和国家登记处收集数据.
- 考克斯的比例危险模型和逻辑双项回归被用于评估风险和确定风险因素; 计算了灵敏度,特异性和预测值.
主要成果:
- 发生TBD的风险随着T-SPOT.TB点数的增加而增加,在十个点以上停滞不前.
- 边界线 (5-7点) 和阳性 (≥8点) 的T-SPOT.TB结果与发生和流行TBD都有很强的关联.
- 对发生的TBD调整后的危险比为边界TBD的5.0和积极结果的8.0;对于流行的TBD调整后的风险比为边界TBD的14.9和积极结果的35.6.
结论:
- 定量T-SPOT.TB值与患结核病的风险有显著的相关性.
- 较高的T-SPOT.TB点位计数,特别是边界和阳性结果,表明事件和流行TBD的风险大幅增加.
- T-SPOT.TB在检测流行TBD时表现出中度敏感性和高特异性.
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