新发传染病电子杂志2023，Vol.8Issue(6)：22-26,5.DOI:10.19871/j.cnki.xfcrbzz.2023.06.004
AIDS合并活动性肺结核评分模型的建立与临床诊断价值评估
Establishment and evaluation of a clinical diagnostic score model for AIDS complicated with active pulmonary tuberculosis
摘要
Abstract
Objective To establish a scoring model for the clinical diagnosis of active pulmonary tuberculosis in patients with AIDS using common clinical indicators and to evaluate the predictive performance of the model.Method A total of 229 patients admitted to the Department of Infectious Diseases,Liuzhou People's Hospital,from October 1,2014,to September 30,2021,were included in the study.Among them,there were 104 cases of AIDS combined with active pulmonary tuberculosis and 125 cases of AIDS combined with other non-tuberculous pulmonary diseases.Univariate analysis and binary logistic regression analysis were used to select variables favorable for diagnosing active pulmonary tuberculosis in AIDS patients.A clinical scoring model for the diagnosis of active pulmonary tuberculosis in AIDS was established,and the predictive ability of the model was assessed.Result In this clinical diagnostic scoring model,six variables were analyzed:cough and sputum symptoms(7 points),CD4+T lymphocyte count(12 points),upper lobe lung lesions(6 points),multi-segment lung lesions(7 points),lung lesions with mediastinal lymphadenopathy(7 points),and unilateral pleural effusion(6 points).When the score was greater than 24 points,the area under the curve for clinical diagnosis of active pulmonary tuberculosis in AIDS patients was 0.911(95%CI 0.864-0.958)(P＜0.05).The sensitivity and specificity were 82.2%and 92.0%,respectively.The positive predictive value and negative predictive value were 89.6%and 86.9%,respectively.The results obtained from the validation group achieved an accuracy of 88.2%(60/68).Conclusion The clinical diagnostic scoring model for active pulmonary tuberculosis in AIDS patients established in this study is simple to use in clinical practice and has good predictive and pre-judgment efficacy for evaluating whether HIV-infected individuals with a CD4+T lymphocyte count≤200/μl are combined with active pulmonary tuberculosis.关键词
AIDS/活动性肺结核/机会性感染/临床诊断评分/CD4+T淋巴细胞Key words
Acquired immune deficiency syndrome/Active pulmonary tuberculosis/Opportunistic infection/Clinical diagnostic score/CD4+T lymphocyte分类
医药卫生引用本文复制引用
莫胜林,孔晋亮,黄云,黄小红,覃锦玉,陈涛,胡家光,蒙达礼,张鹏,蒋忠胜..AIDS合并活动性肺结核评分模型的建立与临床诊断价值评估[J].新发传染病电子杂志,2023,8(6):22-26,5.基金项目
1.2021年国家临床重点专科建设项目(感染性疾病科) （感染性疾病科）
2.广西医药卫生科研课题(Z-B20221309,Z-B20221305,Z-B20221375) （Z-B20221309,Z-B20221305,Z-B20221375）
3.柳州市科技计划项目(2019BJ20601) （2019BJ20601）
4.柳州市科技计划项目(2021CBC0107) （2021CBC0107）
