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尿液白细胞联合检测及血液中结核菌素皮肤试验（TB-DOT）和结核感染T细胞检测（T-SPOT.TB）对肾结核的诊断价值

Diagnostic value of the combined test of leukocytes in urine and TB-DOT and T-SPOT.TB in blood for urinary tuberculosis.

作者信息

Li Yanyan, Wang Yachun, Wei Lukuan, Wang Wei

机构信息

Medical Laboratory, Henan Provincial Chest Hospital of Zhengzhou University, Zhengzhou, China.

Henan Provincial Key Laboratory of Tuberculosis Diagnostic Medicine, Zhengzhou, China.

出版信息

Front Microbiol. 2025 Mar 5;16:1535490. doi: 10.3389/fmicb.2025.1535490. eCollection 2025.

DOI:10.3389/fmicb.2025.1535490
PMID:40109963
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11919865/
Abstract

BACKGROUND

This study aims to evaluate the clinical utility of routine urinary tests and renal function assessments, as well as the Tuberculosis antibody test (TB-DOT) and T-cell spot tests for TB infection (T-SPOT.TB), either individually or in combination, for diagnosing urinary tuberculosis (UTB).

METHODS

We conducted a retrospective analysis of urinary routine tests, renal function tests, TB-DOT, and T-SPOT.TB-administered alone or in combination-in 95 patients suspected of having UTB from January 2020 to December 2022 at our institution.

RESULTS

Significant differences were observed in the levels or positivity of white blood cells (WBC), red blood cells (RBC), creatinine (Crea), TB-DOT, and T-SPOT.TB between the UTB group and the non-UTB group ( < 0.05). Among the individual tests, T-SPOT.TB exhibited the highest specificity and positive predictive value (PPV), while WBC demonstrated the highest area under the curve (AUC). Both TB-DOT and RBC showed relatively good sensitivity. Additionally, WBC levels correlated with both TB-DOT and T-SPOT.TB results. The combination of WBC, TB-DOT, and T-SPOT.TB provided the best sensitivity, negative predictive value (NPV), and AUC when evaluated in parallel with the other tests.

CONCLUSION

For the early identification of UTB, the sensitivity of T-SPOT.TB and TB-DOT tests is superior to that of routine urinary and renal function tests. The parallel combination of WBC, TB-DOT, and T-SPOT.TB offers enhanced diagnostic efficacy for UTB, facilitating rapid clinical diagnosis.

摘要

背景

本研究旨在评估常规尿液检查、肾功能评估以及结核抗体检测（TB-DOT）和结核感染T细胞斑点试验（T-SPOT.TB）单独或联合使用对诊断泌尿系统结核（UTB）的临床效用。

方法

我们对2020年1月至2022年12月在我院疑似患有UTB的95例患者进行了回顾性分析，这些患者单独或联合进行了尿常规检查、肾功能检查、TB-DOT和T-SPOT.TB检测。

结果

UTB组和非UTB组之间白细胞（WBC）、红细胞（RBC）、肌酐（Crea）、TB-DOT和T-SPOT.TB的水平或阳性率存在显著差异（<0.05）。在单项检测中，T-SPOT.TB表现出最高的特异性和阳性预测值（PPV），而WBC的曲线下面积（AUC）最高。TB-DOT和RBC的敏感性都相对较好。此外，WBC水平与TB-DOT和T-SPOT.TB结果均相关。当与其他检测并行评估时，WBC、TB-DOT和T-SPOT.TB的联合检测提供了最佳的敏感性、阴性预测值（NPV）和AUC。

结论

对于UTB的早期识别，T-SPOT.TB和TB-DOT检测的敏感性优于常规尿液和肾功能检查。WBC、TB-DOT和T-SPOT.TB的联合检测为UTB提供了更高的诊断效能，有助于快速临床诊断。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f5b5/11919865/89039fa26ea6/fmicb-16-1535490-g0005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f5b5/11919865/de540ce1997a/fmicb-16-1535490-g0001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f5b5/11919865/9c26d6276b6f/fmicb-16-1535490-g0002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f5b5/11919865/a1d7aa1ea889/fmicb-16-1535490-g0003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f5b5/11919865/c3950ea9a6a8/fmicb-16-1535490-g0004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f5b5/11919865/89039fa26ea6/fmicb-16-1535490-g0005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f5b5/11919865/de540ce1997a/fmicb-16-1535490-g0001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f5b5/11919865/9c26d6276b6f/fmicb-16-1535490-g0002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f5b5/11919865/a1d7aa1ea889/fmicb-16-1535490-g0003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f5b5/11919865/c3950ea9a6a8/fmicb-16-1535490-g0004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f5b5/11919865/89039fa26ea6/fmicb-16-1535490-g0005.jpg

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