| 卢鹏,刘巧,竺丽梅,孔雯,丁晓艳,周扬,陆伟.中国东部地区结核菌素试验诊断结核病感染临界值的确定：基于人群的现况调查[J].中华流行病学杂志,2020,41(3):363-367 |
| 中国东部地区结核菌素试验诊断结核病感染临界值的确定：基于人群的现况调查 |
| Selection of the cutoff value on tuberculin skin test in diagnosing tuberculosis infection: a population-based cross-sectional study in Eastern China |
| 收稿日期:2019-06-11 出版日期:2020-04-01 |
| DOI：10.3760/cma.j.issn.0254-6450.2020.03.016 |
| 中文关键词: 结核菌素试验 结核病潜伏性感染 临界值 γ-干扰素释放试验 |
| 英文关键词: Tuberculin skin test Latent tuberculosis infection Cutoff value Interferon-gamma release assays |
| 基金项目:“六个一工程”拔尖人才科研项目（LGY2017083）；江苏省研究生科研与实践创新计划项目（KYCX19-1131） |
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| 中文摘要: |
| 目的 确定结核菌素试验的临界值来降低其诊断结核病潜伏性感染的假阳性。方法 测量受试者的FPG值，同时对受试者做结核菌素试验和QuantiFERON-TB（QFT）Gold In-Tube检测。以QFT为金标准，确定结核菌素试验（TST）试验的临界值。结果 共有5 405名参与者，其中1 104名（20.4%）QFT阳性。在5 405例患者中，PPD硬结直径为10.25 mm时诊断价值最高，其灵敏度为0.731，特异度为0.727。将受试者分为正常人、有糖尿病史患者、新确诊糖尿病患者，硬结直径分别在11.25 mm、10.25 mm和11.25 mm时诊断价值最高，其灵敏度和特异度分别为0.701、0.837、0.824和0.805、0.821、0.778。结论 本研究证实，以10~12 mm作为结核病潜伏性感染诊断的临界值可以大大提高结核菌素试验的特异性。 |
| 英文摘要: |
| Objective To confirm the cutoff induration diameter of tuberculin skin test (TST) so as to decrease the false positive of the TST. Methods Fasting blood glucose test, TST and Quanti FERON-TB (QFT) Gold In-Tube test were administered to recruit participants at the baseline stage. QFT was used as the gold standard to determine the cutoff of the TST test. Results Overall, 5 405 participants were enrolled in this study, of whom 1 104 (20.4%) were QFT positive. Among all the 5 405 participants that without stratification, diagnostic value reached the highest when the induration diameter was 10.25 mm with sensitivity and specificity as 0.731 and 0.727, respectively. When the participants were divided into groups as nondiabetics, confirmed diabetics, undiagnosed diabetics, the sensitivities and specificities appeared as 0.701, 0.837, 0.824 and 0.805, 0.821, 0.778 with induration diameters as 11.25 mm, 10.25 mm and 11.25 mm, respectively. Conclusions Findings of this study confirmed that the specificity of tuberculin test could be significantly improved by using 10-12 mm as the cutoff value for diagnosing the latent tuberculosis infection. |
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