摘要
目的评估6种结核分枝杆菌检测方法对不典型肾结核的早期诊断价值,为临床诊断提供参考。方法收集河北省胸科医院泌尿外科2015年10月至2020年12月诊治的不典型肾结核患者46例(结核组)、非结核肾病患者53例(对照组),分别采用结核感染T细胞斑点试验(T-SPOT.TB)、结核菌素试验(PPD试验)、涂片抗酸杆菌染色镜检(AFB镜检法)、BACTEC MGIT960液体培养(简称液体培养法)、结核分枝杆菌脱氧核糖核酸实时荧光定量PCR(TB-DNA FQ-PCR)、利福平耐药实时荧光定量核酸扩增技术(GeneXpert MTB/RIF),以结核菌培养及病理结果为金标准,比较不同检测方法在不典型肾结核临床诊断中的价值。结果T-SPOT.TB灵敏度(95.65%)高于PPD试验(73.91%),差异有统计学意义(McNemar检验:P=0.002);GeneXpert MTB/RIF的灵敏度为84.78%,高于AFB镜检法(4.35%)、液体培养法(28.26%)和TB-DNA FQ-PCR(58.70%),差异有统计学意义(McNemar检验:P均<0.001),GeneXpert MTB/RIF与三者的特异性无统计学差异(McNemar检验:P=1.000、0.500和0.250)。结论T-SPOT.TB与GeneXpert MTB/RIF在不典型肾结核的筛查和病原学诊断中有较高的灵敏度和应用价值,推荐应用。
Objective To evaluate the diagnostic value of six detection methods of Mycobacterium tuberculosis in atypical renal tuberculosis,so as to provide references for clinical diagnosis.Methods There were 46 patients with atypical renal tuberculosis(tuberculosis group)and 53 patients with non-tuberculous nephropathy(control group)who were diagnosed and treated in Department of Urology of Hebei Provincial Chest Hospital from October 2015 to December 2020 enrolled.They were diagnosed by T-cell spot test of tuberculosis infection(T-SPOT.TB),tuberculin test(PPD test),acid fast bacillus(AFB)staining microscopy(AFB microscopy),BACTEC MGIT960 liquid culture(liquid culture method),Mycobacterium tuberculosis deoxyribonucleic acid real-time fluorescence quantitative polymerase chain reaction(TB-DNA FQ-PCR)and rifampicin resistant real-time fluorescent quantitative nucleic acid amplification detection technology(GeneXpert MTB/RIF),respectively.The culture of Mycobacterium tuberculosis or pathological tissue result was considered as the golden standard,and these detection methods were compared in the clinical diagnosis of atypical renal tuberculosis.Results The sensitivity of T-SPOT.TB(95.65%)was significantly higher than that of PPD test(73.91%)(McNemar:P=0.002).The sensitivity of GeneXpert MTB/RIF was 84.78%,which was higher than those of AFB microscopy(4.35%),liquid culture(28.26%)and TB-DNA FQ-PCR(58.70%)(McNemar:P all<0.001).There was no significant difference in the specificity between GeneXpert MTB/RIF and three other detection methods(McNemar:P=1.000,0.500 and 0.250).Conclusions T-SPOT.TB and GeneXpert MTB/RIF have high sensitivity and application value in the screening of atypical renal tuberculosis and related etiological diagnosis,and are recommended for clinical application.
作者
李崇斌
尹航
方鹏
朱晓黎
刘建震
范正超
Li Chongbin;Yin Hang;Fang Peng;Zhu Xiaoli;Liu Jianzhen;Fan Zhengchao(Department of Urology,Hebei Provincial Chest Hospital,Shijiazhuang 050041,China;Molecular Biology Laboratory,Hebei Provincial Chest Hospital,Shijiazhuang 050041,China)
出处
《国际流行病学传染病学杂志》
CAS
2022年第3期183-187,共5页
International Journal of Epidemiology and Infectious Disease
基金
河北省卫生健康委员会青年科技课题(20170415)。
关键词
结核
肾
诊断
利福平耐药实时荧光定量核酸扩增技术
结核感染T细胞斑点试验
Tuberculosis,renal
Diagnosis
Rifampicin resistant real-time fluorescent quantitative nucleic acid amplification detection technology
T-cell spot test of tuberculosis infection
