结核感染T细胞斑点试验联合血清ADA、SAA、CA125对活动性肺结核诊断及治疗转归的评估价值

摘要 目的：探讨结核感染T细胞斑点试验（T-SPOT.TB）联合血清腺苷脱氨酶（ADA）、淀粉样蛋白A（SAA）、糖类抗原125（CA125）对活动性肺结核（APTB）诊断及治疗转归的评估价值。方法：选取2021年10月至2022年10月湖南省胸科医院收治的137例APTB患者（APTB组）和80例非APTB患者（对照组），所有APTB患者接受常规抗结核治疗，根据治疗后转归情况分为转归组（92例）和未转归组（45例）。治疗前进行T-SPOT.TB，并检测血清ADA、SAA、CA125水平。受试者工作特征（ROC）曲线分析T-SPOT.TB联合血清ADA、SAA、CA125诊断APTB和预测治疗转归的效能。结果：APTB组T-SPOT.TB阳性率，血清ADA、SAA、CA125水平高于对照组（P＜0.05）。未转归组T-SPOT.TB阳性率，血清ADA、SAA、CA125水平高于转归组（P＜0.05）。T-SPOT.TB联合血清ADA、SAA、CA125诊断APTB以及预测其治疗转归的曲线下面积（AUC）分别为0.917、0.833，高于单一指标。结论：APTB患者T-SPOT.TB阳性率增加，血清ADA、SAA、CA125水平增高，与抗结核治疗后转归不良有关，T-SPOT.TB联合血清ADA、SAA、CA125在APTB诊断和治疗转归评估中具有较高价值。

Evaluation Value of Tuberculosis Infection T Cell Spot Test Combined with Serum ADA, SAA and CA125 in the Diagnosis and Treatment Outcome of Active Pulmonary Tuberculosis

ABSTRACT Objective: To investigate the evaluation value of tuberculosis infection T cell spot test (T-SPOT.TB) combined with serum adenosine deaminase (ADA), amyloid A (SAA) and carbohydrate antigen 125 (CA125) in the diagnosis and treatment outcome of active pulmonary tuberculosis (APTB). Methods: 137 APTB patients (APTB group) and 80 non-APTB patients (control group) who were admitted to Hunan Chest Hospital from October 2021 to October 2022 were selected, all APTB patients received routine anti-tuberculosis treatment, patients were divided into outcome group (92 cases) and non-outcome group (45 cases) according to the treatment outcome. T-SPOT.TB was performed , and serum ADA, SAA and CA125 levels were detected before treatment. The efficacy of T-SPOT.TB combined with serum ADA, SAA and CA125 in the diagnosis of APTB and predicting treatment outcome were analyzed by receiver operating characteristic (ROC) curve. Results: The positive rate of T-SPOT.TB and the levels of serum ADA, SAA and CA125 in APTB group were higher than those in control group(P<0.05). The positive rate of T-SPOT.TB and the levels of serum ADA, SAA and CA125 in non-outcome group were higher than those in outcome group(P<0.05). The area under the curve (AUC) of T-SPOT.TB combined with serum ADA, SAA and CA125 in diagnosing APTB and predicting its treatment outcome were 0.917 and 0.833 respectively, which were higher than those of single index. Conclusion: The positive rate of T-SPOT.TB in APTB patients increased, and the levels of serum ADA, SAA and CA125 increased, which were relate to the poor prognosis after anti-tuberculosis treatment, T-SPOT.TB combined with serum ADA, SAA and CA125 had high value in the diagnosis and treatment outcome evaluation of APTB.