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通过GeneXpert MTB/RIF测试在儿科患者中检测耐药结核病的诺莫格拉姆预测模型
Lingchao Wang1, Weiwei Ma1, Na Wei1
1Department of Pediatric, The First Affiliated Hospital of Henan Medical University (formerly The First Affiliated Hospital of Xinxiang Medical University), Weihui, 453100, People's Republic of China.
Infection and drug resistance
|February 19, 2026
概括
一种新的名图有效预测儿科患者耐药结核病 (DR-TB) 风险,确定再治疗和吸烟是关键因素. 基因Xpert MTB/RIF测定显示了儿童早期DR-TB查的前景.
科学领域:
- 儿童传染病 儿童传染病
- 临床诊断 临床诊断 临床诊断
- 放射学和成像学 放射学和成像学
背景情况:
- 结核病 (TB) 仍然是一个重大的全球卫生挑战,特别是在儿童群体中.
- 耐药结核病 (DR-TB) 呈现出复杂的治疗方案,需要准确的风险预测和诊断工具.
- 识别儿童DR-TB的风险因素和开发预测模型对于及时干预至关重要.
研究的目的:
- 开发和验证一种临床成像集成的诺米克图,用于预测儿科患者 (≤18岁) 的DR-TB风险.
- 评估GeneXpert MTB/RIF测定在这个年龄组中检测DR-TB的诊断性能.
- 在住院儿童和青少年中确定与DR-TB相关的独立风险因素.
主要方法:
- 对223名年龄≤18岁的结核病患者进行了回顾性研究.
- 对抗药性结核病 (DR-TB) 和药物敏感结核病 (DS-TB) 组之间的药物耐药性概况的分析和临床/成像特征的比较.
- 多变量后勤回归以确定DR-TB风险因素和开发一个名ogram预测模型.
主要成果:
- 在26.5%的患者中存在DR-TB,其中13.5%患有多抗药性结核病.
- 确定了独立的DR-TB风险因素:重新治疗 (OR=5.303),吸烟史 (OR=4.129),右中叶参与 (OR=3.004) 和腔腔形成 (OR=2.950).
- 诺莫格拉姆模型证明了有效的预测性能 (AUC=0.776). 基因Xpert MTB/RIF 显示了对利芬素耐药性的87.5%敏感度和90.48%特异性.
结论:
- 一种临床成像的诺莫格拉姆模型显示了在儿科患者中对DR-TB风险的良好预测价值.
- 重新治疗,吸烟史,右中叶参与和腔腔形成是DR-TB的重要预测因素.
- 基因Xpert MTB/RIF测定是一种潜在的DR-TB儿童早期查工具,需要进一步验证.
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