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XpertMTB/RIF联合T-SPOT.TB对结核性胸膜炎及其耐药性的临床研究 被引量:11
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作者 孙海柏 张丽霞 +5 位作者 刘佳庆 郭明日 李玉明 冯冉冉 刘雅 谢怡 《中国现代医学杂志》 CAS 2018年第11期93-97,共5页
目的探讨利福平耐药实时荧光定量核酸扩增技术(Xpert MTB/RIF)、结核感染T细胞斑点检测(T-SPOT.TB)胸腔积液对结核性胸膜炎及其耐药性的临床价值。方法选取2012年6月-2016年10月于天津市海河医院就诊的确诊结核性胸膜炎患者101例;同期... 目的探讨利福平耐药实时荧光定量核酸扩增技术(Xpert MTB/RIF)、结核感染T细胞斑点检测(T-SPOT.TB)胸腔积液对结核性胸膜炎及其耐药性的临床价值。方法选取2012年6月-2016年10月于天津市海河医院就诊的确诊结核性胸膜炎患者101例;同期选取院内其他疾病合并胸腔积液的患者79例,分别留取胸腔积液标本进行Xpert MTB/RIF和T-SPOT.TB检测,同时完成胸腔积液BACTE C MG1T960液体培养以及药物敏感性等相关性检查,分别与临床诊断和BACTEC MG1T960液体培养作为参考标准进行评价。结果结核性胸膜炎组Xpert MTB/RIF和T-SPOT.TB的敏感性分别为82.18%和88.12%,两组比较,差异有统计学意义(P<0.05),特异性分别为96.10%和98.73%,差异无统计学意义(P>0.05);Xpert MTB/RIF和T-SPOT.TB与BACTEC MU1T960液体培养的Kappa值分别为0.277和0.668;Xpert MTB/RIF在诊断利福平耐药率与BACTEC MU1T960液体培养Kappa值为0.786。结论 T-SPOT.TB的敏感性结合Xpert MTB/RIF的特异性不但缩短了诊断时间而且提高了胸膜炎诊断的准确性,减少误诊率,为结核性胸膜炎的早期诊断提供了有利的帮助,Xpert MTB/RIF能对利福平的耐药性做出快速的判断。 展开更多
关键词 结核性胸膜炎 联合 实时荧光定量核酸扩增技术 结核感染T细胞斑点检测
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Analysis of Serum Metabolic Profile by Ultra-performance Liquid Chromatography-mass Spectrometry for Biomarkers Discovery: Application in a Pilot Study to Discriminate Patients with Tuberculosis 被引量:6
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作者 Shuang feng Yan-Qing Du +3 位作者 Li Zhang LeiZhang ran-ran feng Shu-Ye Liu 《Chinese Medical Journal》 SCIE CAS CSCD 2015年第2期159-168,共10页
Background:Tuberculosis (TB) is a chronic wasting inflammatory disease characterized by multisystem involvement,which can cause metabolic derangements in afflicted patients.Metabolic signatures have been exploited ... Background:Tuberculosis (TB) is a chronic wasting inflammatory disease characterized by multisystem involvement,which can cause metabolic derangements in afflicted patients.Metabolic signatures have been exploited in the study of several diseases.However,the serum that is successfully used in TB diagnosis on the basis of metabolic profiling is not by much.Methods:Orthogonal partial least-squares discriminant analysis was capable of distinguishing TB patients from both healthy subjects and patients with conditions other than TB.Therefore,TB-specific metabolic profiling was established.Clusters of potential biomarkers for differentiating TB active from non-TB diseases were identified using Mann-Whitney U-test.Multiple logistic regression analysis of metabolites was calculated to determine the suitable biomarker group that allows the efficient differentiation of patients with TB active from the control subjects.Results:From among 271 participants,12 metabolites were found to contribute to the distinction between the TB active group and the control groups.These metabolites were mainly involved in the metabolic pathways of the following three biomolecules:Fatty acids,amino acids,and lipids.The receiver operating characteristic curves of3D,7D,and 11D-phytanic acid,behenic acid,and threoninyl-γ-glutamate exhibited excellent efficiency with area under the curve (AUC) values of 0.904 (95% confidence interval [CI]:0.863-0.944),0.93 (95% CI:0.893-0.966),and 0.964 (95% CI:0.941-0.988),respectively.The largest and smallest resulting AUCs were 0.964 and 0.720,indicating that these biomarkers may be involved in the disease mechanisms.The combination of lysophosphatidylcholine (18∶0),behenic acid,threoninyl-γ-glutamate,and presqualene diphosphate was used to represent the most suitable biomarker group for the differentiation of patients with TB active from the control subjects,with an AUC value of 0.991.Conclusion:The metabolic analysis results identified new serum biomarkers that can distinguish TB from non-TB diseases.The metabolomics-based analysis provides specific insights into the biology of TB and may offer new avenues for TB diagnosis. 展开更多
关键词 METABOLITES Orthogonal Partial Least-squares Discriminant Analysis SERUM TUBERCULOSIS Ultra-performance LiquidChromatography-mass Spectrometry
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