开发和验证一个名图表,用于预测肺结核患者的虚假阴性IGRA结果,使用倾向性得分匹配
Feng Zhang1, Yong Gao1, Tuantuan Li1
1No.2 People's Hospital of Fuyang City, Fuyang Infectious Disease Clinical College of Anhui Medical University, Fuyang, Anhui, China.
PloS one
|July 2, 2025
概括
较低的红细胞 (RBC) 和专蛋白 (ALB) 水平,以及高的中性粒细胞与淋巴细胞比率 (NLR),预测肺结核 (PTB) 患者的错误阴性干扰素马释放试验 (IGRA) 结果. 一个名录图有助于识别高风险个体.
科学领域:
- 医学诊断 医学诊断 医学诊断
- 传染性疾病 传染性疾病
- 临床生物化学 临床生物化学
背景情况:
- 干扰素-释放测试 (IGRAs) 对于诊断结核病 (TB) 是至关重要的.
- 假阴性IGRA结果可以阻碍肺结核 (PTB) 的及时诊断和治疗.
- 识别与假阴性IGRA结果相关的因素对于提高诊断准确性至关重要.
研究的目的:
- 调查导致PTB患者假阴性IGRA结果的因素.
- 开发和验证一个名录模型,用于预测PTB的IGRA假阴性.
- 加强PTB诊断和管理的临床决策.
主要方法:
- 一项回顾性研究,涉及从2023年1月到2024年9月的143名PTB患者.
- 倾向性得分匹配 (PSM) 以平衡IGRA阴性/病原体阳性和IGRA阳性/病原体阳性组之间的基线特征.
- 后勤回归分析以确定独立预测因素,然后进行名ogram构建和验证.
主要成果:
- 在PSM之后,每个组中有55名患者.
- 较低的红细胞计数 (RBC),白蛋白 (ALB) 和较高的中性粒细胞与淋巴细胞比率 (NLR) 独立地与假阴性IGRA结果相关.
- 诺米图表显示了良好的校准 (χ2=4.482,P=0.811) 和预测性能 (AUC=0.764).
结论:
- 降低红细胞/ALB和升高的NLR是与PTB虚负IGRA结果相关的关键因素.
- 开发的三变量名图有效地预测IGRA假阴性.
- 该工具有助于识别高风险出现假阴性IGRA结果的PTB患者,特别是营养不良或炎症患者.
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