结核抗体对老年结核病患者的诊断价值探讨

目的评价结核抗体对老年结核病患者的诊断价值。方法选择老年住院患者148例,其中确诊结核病38例,采用酶联免疫吸附试验（ELISA）检测其结核抗体,用临床流行病学方法分别计算结核抗体检测对结核病诊断的敏感性、特异性、似然比、预测值及不同患病率下的验后概率。结果结核抗体检测对结核病诊断的敏感性和特异性分别为55.26%和90.00%,阳性和阴性似然比分别为5.526和0.497,阳性预测值为65.63%,阴性预测值为85.34%。患病率为25.68%时,验后概率为65.64%。结论结核抗体检测对老年结核病患者的诊断价值有限,临床医师应谨慎对待结核抗体检测阳性结果,其诊断价值与所处医院患者结核病患病率有关。

The diagnosis value of tuberculosis antibody test in elderly patients with tuberculosis

Objective To evaluate the diagnosis value of tuberculosis antibody test in elderly patients with tuberculosis.Methods 148 cases of hospitalized elderly patients including 38 diagnosed with tuberculosis were tested the tuberculosis antibody by enzyme-linked immunosorbent assay（ELISA）.The sensitivity,specificity,diagnostic likelihood ratio,predictive value and post-test probability were determined and calculated by clinical epidemiology method respectively.Results The results for the tuberculosis antibody test were sensitivity 55.26%,specificity 90.00%,positive diagnostic likelihood ratio 5.526,negative diagnostic likelihood ratio 0.497,positive predictive value 65.63%,negative predictive value 85.34% and post-test probability 65.64% in 25.68% of prevalence.Conclusions This study shows that tuberculosis antibody test has limited value for the diagnosis of elderly patients with tuberculosis.Clinical physicians should pay attention to the positive results of tuberculosis antibody tests.The value of diagnosis is related to the prevalence of tuberculosis in the hospital.