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    FCM联合ICK诊断艾滋病合并肺结核的临床价值

    Clinical value of FCM and ICK in diagnosing AIDS patients with pulmonary tuberculosis

    • 摘要: 目的 探析流式细胞术(FCM)检测胞内细胞因子(ICK)法诊断艾滋病合并肺结核的临床价值,为疾病的早期诊断和治疗提供依据。方法 选取2017年8月—2018年5月于西安市第八医院诊治的38例艾滋病合并肺结核患者(感染组),44例单纯艾滋病患者(高危组)以及20例健康人群(对照组)。采用FCM联合ICK法检测外周血中因被结核菌抗原刺激而分泌重组人干扰素γ(IFN-γ)的特异性T细胞的比例;并与结核分枝杆菌相关γ-干扰素体外释放定量试验(TB-IGRA)检测结果进行对比,通过ROC曲线分析诊断的临床价值。结果 FCM联合ICK法诊断的灵敏度为92.1%、特异度为96.9%,约登指数为0.889,均优于与TB-IGRA检测(灵敏度71.1%、特异度89.1%、约登指数0.602)。FCM联合ICK法的ROC曲线下面积(AUG)为0.842,95%CI:0.763~0.921;TB-IGRA检测的AUG为0.780,95%CI:0.687~0.872。结论 FCM联合ICK法诊断艾滋病合并肺结核的敏感度和特异度较高,有较高的诊断效能。

       

      Abstract: Objective To evaluate the clinical value of detection of intracellular cytokine(ICK) by flow cytomeytry(ICCFC) in diagnosing AIDS patients with pulmonary tuberculosis,and to provide evidence for early diagnosis and treatment of the disease.Methods A total of 38 AIDS patients with pulmonary tuberculosis(an infected group) who were admitted into Xi’an Eighth Hospital from August 2017 to May 2018,44 AIDS patients(a high risk group) and 20 healthy subjects(a control group) were enrolled.Their proportions of specific T cells secreting interferon-γ(IFN-γ)in the peripheral blood due to stimulation by tuberculosis antigen were detected by FCM and ICK,and compared with the results of Mycobacterium tuberculosis related interferon γ release assay(TB-IGRA).The clinical value of the diagnosis was analyzed by ROC curve.Results FCM and ICK showed 92.1% sensitivity,96.9% specificity and the Youden index of 0.889,which were better than those of TB-IGRA(sensitivity 71.1%,specificity 89.1%,and Youden index0.602).ICCFC method under the ROC curve area(AUG) was 0.842(95% CI:0.763-0.921),in contrast with TB-IGRA detection AUG 0.780(95% CI:0.687-0.872).Conclusions FCM and ICK has higher sensitivity and specificity for diagnosing AIDS patients with pulmonary tuberculosis,with good diagnostic efficacy.

       

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