Analysis Of The Clinical Value Of Pneumoconiosis Complicated With Pulmonary Tuberculosis Imaging And Laboratory Test Index Of Combined Application

Objectives By comparing the differences between the imaging and laboratory test indexes of pneumoconiosis tuberculosis group and pneumoconiosis group, the characteristics of pneumoconiosis tuberculosis were selected, the clinical significance of the diagnosis of pneumoconiosis tuberculosis was evaluated.Methods Laboratory testing is completed by the hospital laboratory, the students are responsible for data collection, fill in the questionnaire. The results of imaging examination were determined by senior doctors, and the production of the questionnaire was recorded. The data were obtained from Epidata3.1 database and analyzed by SPSS18.0 statistical software.Single factor analysis(group comparison)using t test or chi square test, multivariate analysis using Logistic regression model;measurement data were analyzed. The sensitivity, specificity, Jorden index,kappa value,ROC value,the sensitivity, specificity, Jorden index, kappa value and ROC curve were calculated.Results 1 Pneumoconiosis combined with tuberculosis group mixing industry and trade were more than those in pneumoconiosis group(P<0.05);pneumoconiosis combined with tuberculosis group one phase was significantly higher than that of patients with pneumoconiosis group three phase(P<0.01);pneumoconiosis combined with tuberculosis group appear hemoptysis(P<0.05)and low(P<0.01),night sweats(P<0.01),fatigue(P< 0.01)the number of cases was significantly higher than that of the pneumoconiosis group, pneumoconiosis group palpitations(P<0.01),dyspnea(P<0.05) were significantly more than pneumoconiosis combined with tuberculosis group. 2 Logisitic regression showed that compared with the one stage pneumoconiosis group with three stages of pneumoconiosis,OR=43.471(P < 0.01);with hemoptysis,OR=7.119(P<0.05); low thermal performance,OR=26.655(P<0.01),these were the risk factors of pneumoconiosis combined with tuberculosis. 3 The optimal critical value(cutoff value) of C reactive protein in the diagnosis of pneumoconiosis was 6.5.The sensitivity was 71%,specificity was 85%,Youden index(YI) was 0.56,the rank correlation coefficient is 0.566 and the pneumoconiosis tuberculosis group(P<0.01),the area of C reactive protein in diagnosis of pneumoconiosis tuberculosis under curve ROC(AUC)0.801;interferon gamma release test sensitivity was 86%,specificity 53%,YI is 0.39,kappa=0.39(P<0.01), AUC=0.695 ASSURE TB Rapid; the sensitivity was 48%, specificity was 89%, YI was 0.37, kappa=0.37(P<0.01), AUC=0.685; imaging performance of cavity sensitivity was 36%, specificity was 98%, YI was 0.34, kappa=0.34(P<0.01),AUC=670;imaging sheet performance sensitivity was 73%,specificity was 56%,YI was 0.29,kappa=0.29(P<0.01), AUC=0.645; imaging performance of mass sensitivity was 30%,specificity was 91%,YI was 0.21,kappa=0.21(P<0.01,AUC=0.605).4 Diagnostic efficiency of the optimal combination model for imaging study empty,clumps,flake parallel scheme and laboratory examination C reactive protein,interferon gamma release test in parallel scheme in series. The results showed that the sensitivity of this method was 92%,specificity was 74%, Youden index(Yi) of 0.66,kappa value was 0.66(P<0.01),the area under the ROC curve(AUC) of 0.825.Conclusions 1 The diagnostic efficiency of each diagnostic method was from high to low sort of C reactive protein,gamma interferon release test,TB Rapid ASSURE,imaging findings,imaging findings,imaging mass.2 The best combination model of diagnosis efficiency is the imaging cavity,the mass,the parallel program and the laboratory examination of C reaction protein,gamma interferon release test parallel program in series.