摘要
目的:比较支气管肺泡灌洗液(BALF)四种检测方法在支气管结核诊断中的应用价值。方法:选取200例疑似支气管结核患者,均采取改良抗酸染色法、结核抗体(TB-Ab)检测、实时荧光定量核酸扩增(Xpert MTB/RIF)法、960培养法进行检测。基于病理学联合临床检查结果,比较四种检查方法准确性、特异度与灵敏度。结果:改良抗酸染色法检测敏感度85.64%(155/181),特异度63.16%(12/19),准确性83.50%(167/200);TB-Ab检测敏感度69.06%(125/181),特异度47.37%(9/19),准确性67.00%(134/200);Xpert MTB/RIF检测敏感度92.27%(167/181),特异度57.89%(11/19),准确性89.00%(178/200),Kappa值0.44;960培养法敏感度71.27%(129/181),特异度42.11%(8/19),准确性68.50%(137/200)。改良抗酸染色法与Xpert MTB/RIF法准确性、灵敏度明显高于TB-Ab检测与960培养法(P<0.05),且Xpert MTB/RIF法敏感度明显高于改良抗酸染色法(P<0.05)。结论:相较于TB-Ab检测、960培养法,BALF改良抗酸染色法与Xpert MTB/RIF法对支气管结核诊断准确性更高。
Objective:To compare the application value of four detection methods of bronchoalveolar lavage fluid(BALF)in the diagnosis of bronchial tuberculosis.Methods:200 patients with suspected bronchial tuberculosis were enrolled in the study.All of them were detected by modified acid-fast staining,tuberculosis antibody(TB-Ab),real-time quantitative nucleic acid amplification(Xpert MTB/RIF)and 960 culture method.Based on the results of pathology combined with clinical examinations,the accuracy,specificity and sensitivity of the four examination methods were compared.Results:The sensitivity of the modified acid-fast staining method was 85.64%(155/181),the specificity was 63.16%(12/19),the accuracy was 83.50%(167/200);the sensitivity of TB-Ab detection was 69.06%(125/181),the specificity was 47.37%(9/19),the accuracy was 67.00%(134/200);the sensitivity of Xpert MTB/RIF detection was 92.27%(167/181),the specificity was 57.89%(11/19),the accuracy was 89.00%(178/200),Kappa value was 0.44;the sensitivity of 960 culture method was 71.27%(129/181),the specificity was 42.11%(8/19),the accuracy was 68.50%(137/200).The accuracy and sensitivity of the modified acid-fast staining method and Xpert MTB/RIF method were significantly higher than those of the TB-Ab detection and 960 culture method(P<0.05),and the sensitivity of the Xpert MTB/RIF method was significantly higher than that of the modified acid-fast staining method(P<0.05).Conclusion:Compared with TB-Ab detection and 960 culture method,modified acid-fast staining and Xpert MTB/RIF methods of BALF have higher diagnostic accuracy for bronchial tuberculosis.
作者
高小丽
魏娟
王翠洁
GAO Xiaoli;WEI Juan;WANG Cuijie(Department of Laboratory Medicine,Yulin Hospital of Traditional Chinese Medicine,Shaanxi Province,Yulin 719000)
出处
《陕西医学杂志》
CAS
2020年第12期1673-1676,共4页
Shaanxi Medical Journal
基金
陕西省卫生健康委员会科研课题(2018KF195634)。