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亚临床型肺结核与活动性肺结核的特征比较:一项回顾性队列研究。

Characteristics of subclinical pulmonary tuberculosis compared to active pulmonary tuberculosis: A retrospective cohort study.

作者信息

Zhang Aiping, Wang Wenjie, Wang Zijian, Sheng Haoyu, Yang Jianghua

机构信息

Department of Infectious Diseases, Yijishan Hospital of Wannan Medical College, Wuhu 241001 Anhui, PR China.

出版信息

J Clin Tuberc Other Mycobact Dis. 2025 May 20;40:100535. doi: 10.1016/j.jctube.2025.100535. eCollection 2025 Aug.

Abstract

BACKGROUND

Little is known about subclinical pulmonary tuberculosis (SPTB), and its diagnosis remains challenging. The aim is to analyze the results of laboratory of SPTB and improve clinical understanding and help early diagnosis.

METHOD

This retrospective cohort study was conducted in patients with pulmonary tuberculosis (TB) at a university hospital in China. 138 cases of SPTB were compared with active pulmonary tuberculosis (APTB) (140 cases) and healthy person (HC) (136 cases).

RESULT

The average age of the SPTB group (40.43 ± 19.85 years) was younger than that of the APTB group (50.01 ± 21.49 years) (p < 0.05). The WBC count was elevated in both pulmonary TB groups compared to the HC group(p < 0.05). CRP and CA-125 were higher in the APTB group than in SPTB and HC group (p < 0.05). The CD4+ T cells counts in SPTB group was lower than that in HC group (p < 0.05); although the CD4+ T cells counts in SPTB group was lower than that in APTB group, the difference was not statistically significant (p > 0.05). There were statistically significant differences in CD8 + T cells counts between the three groups (p < 0.05), and the CD8 + T cells counts in two pulmonary TB groups was lower than that in the HC group (p < 0.05), and there was no statistically significant difference between SPTB and APTB group (p > 0.05). The T-SPOT.TB value in SPTB were lower than those in the APTB group (p < 0.05).

CONCLUSION

Patients with SPTB tend to develop the condition at a younger age and are predominantly male. Clinically, we can judge whether SPTB will develop into APTB by monitoring WBC count, CA-125, CRP, T lymphocyte count and T-SPOT.TB value level, in order to achieve the purpose of early diagnosis and treatment.

摘要

背景

关于亚临床肺结核(SPTB)的了解甚少,其诊断仍然具有挑战性。目的是分析SPTB的实验室检查结果,提高临床认识并有助于早期诊断。

方法

这项回顾性队列研究在中国一家大学医院的肺结核(TB)患者中进行。将138例SPTB患者与活动性肺结核(APTB)患者(140例)和健康人(HC)(136例)进行比较。

结果

SPTB组的平均年龄(40.43±19.85岁)低于APTB组(50.01±21.49岁)(p<0.05)。与HC组相比,两个肺结核组的白细胞计数均升高(p<0.05)。APTB组的CRP和CA-125高于SPTB组和HC组(p<0.05)。SPTB组的CD4+T细胞计数低于HC组(p<0.05);尽管SPTB组的CD4+T细胞计数低于APTB组,但差异无统计学意义(p>0.05)。三组之间的CD8+T细胞计数存在统计学差异(p<0.05),两个肺结核组的CD8+T细胞计数低于HC组(p<0.05),SPTB组和APTB组之间无统计学差异(p>0.05)。SPTB组的T-SPOT.TB值低于APTB组(p<0.05)。

结论

SPTB患者发病年龄趋于年轻化,且以男性为主。临床上,可通过监测白细胞计数、CA-125、CRP、T淋巴细胞计数和T-SPOT.TB值水平来判断SPTB是否会发展为APTB,以达到早期诊断和治疗的目的。

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