Clinical and radiographic predictors in diagnosing sputum smear- negative pulmonary tuberculosis in HIV-negative patients： a cross- sectional study in China

作     者：LI Xin-xu JIANG Shi-wen ZHANG Hui JING Kuan-he WANG Li LI Wei-bin LIU Xiao-qiu YAO Hong-yan WANG Li-xia 

作者机构：National Center for Tuberculosis Control and Prevention ChineseCenter for Disease Control and Prevention Beijing 102206 China Chongqing Institution of Tuberculosis Prevention and TreatmentChongqing 400050 China Liaoning Center for Disease Control and Prevention Shenyang110005 China Office of Epidemiology Chinese Center for Disease Control andPrevention Beijing 102206 China 

出 版 物：《Chinese Medical Journal》 (中华医学杂志（英文版）)

年 卷 期：2013年第126卷第19期

页      面：3662-3667页

核心收录：

学科分类：090603[农学-临床兽医学] 0821[工学-纺织科学与工程] 1002[医学-临床医学] 08[工学] 09[农学] 0906[农学-兽医学] 082101[工学-纺织工程] 

基　　金：World Bank Loan/UK Department for International Development Grant Assistant China TB Control Project NTP in China 

主　　题：validation study tuberculosis smear negative pulmonary/radiography 

摘      要：Background In county-level tuberculosis （TB） dispensaries in China,the accurate diagnosis of sputum smear-negative pulmonary tuberculosis （SNPT） needs to be improved by developing and validating clinical and radiographic *** The study was conducted simultaneously in three counties per province in Chongqing Municipality and Liaoning Province in China between May 2005 and May 2006.A total of 432 new SNPT patients who are HIV-negative and more than 15 years old diagnosed by expert panels in county-level TB dispensaries were *** sputum samples were collected for culture before anti-TB treatment,and the treatment outcomes （changes of X-rays） were followed up at the end of the 6th *** Of the 432 SNPT patients,sputum culture positive （9.7%） or culture negative with good changes of X-rays at the end of the 6th month （73.6%） was validated as *** predictive variables were associated with validated SNPT in the multivariate logistic regression model：age ≤55 years old （odds ratio （OR） 5.66; 95% CI 2.69-11.91）,〉60 days of cough （OR 3.73; 95% CI 1.10-12.65）,≥10% of pulmonary consolidation in the lungs （OR 5.40; 95% CI 2.90-10.06）,and pulmonary consolidation in the upper lobe anterior segment （OR 3.00; 95% CI 1.57-5.72）.The area under the receiver operating characteristic curve of the model was 0.77 （95% CI 0.71-0.83）.Conclusion Four predictors of clinical and radiological characteristics that had a good diagnostic performance of SNPT deserve to be recommended as index indicators of SNPT diagnosis in county-level TB dispensaries in China.