摘要
目的探究结核分枝杆菌rpoB基因检测在肺结核合并2型糖尿病患者中的诊断价值。方法选取河北省胸科医院2016年1月至2018年5月住院的单纯肺结核患者125例作为单纯组、肺结核合并2型糖尿病且糖化血红蛋白<9%患者81例作为轻度组、肺结核合并2型糖尿病且糖化血红蛋白>9%患者59例作为重度组;所有患者均接受结核分枝杆菌/利福平耐药实时荧光定量核酸扩增检测(Xpert MTB/RIF)、痰涂片、干扰素试验(T-SPOT.TB)、结核菌培养,以结核菌培养结果为金标准,分析比较不同检测方法的特异性及敏感性。结果三组咳嗽、盗汗、胸痛、厌食、体重减轻、呼吸困难、咯血等症状发生率比较差异均无统计学意义(P>0.05);以结核菌培养为金标准,结果显示,单纯组阳性率63.2%(79/125)低于轻度组76.5%(62/81)和重度组91.5%(54/59),差异有统计学意义(P<0.05);三种检测方式在三组中的诊断特异度比较差异无统计学意义(P>0.05);在单纯组中,Xpert MTB/RIF以及T-SPOT.TB诊断敏感度、准确度高于痰涂片,差异有统计学意义(P<0.05);在轻度组、重度组中,Xpert MTB/RIF诊断敏感度、准确度高于痰涂片以及T-SPOT.TB,差异有统计学意义(P<0.05)。结论与单纯肺结核相比,合并2型糖尿病患者结核分枝杆菌阳性检出率更高。对于肺结核合并2型糖尿病患者,Xpert MTB/RIF诊断敏感度、准确度较好,可用于临床检测。
Objective To explore the diagnostic value of Mycobacterium tuberculosis rpoB gene test for pulmonary tuberculosis with type 2 diabetes.Methods A total of 125 patients with simple pulmonary tuberculosis admitted to Hebei Chest Hospital from January 2016 to May 2018 were selected as the simple group,81 patients with pulmonary tuberculosis combined with type 2 diabetes mellitus and HBA1c<9%were selected as the mild group,and 59 patients with pulmonary tuberculosis combined with type 2 diabetes mellitus and HBA1c>9%were selected as the severe group.All patients received real-time fluorescence quantitative nu-cleic acid amplification test for Mycobacterium tuberculosis and rifampicin resistance(Xpert MTB/RIF),sputum smear,interferon test(T-SPOT.TB),and tuberculosis culture.The specificity and sensitivity of different detection methods were compared with the results of tuberculosis culture as the gold standard.Results There was no significant difference in the incidence of cough,night sweats,chest pain,anorexia,weight loss,dyspnea,and hemoptysis among the three groups(P>0.05).Taking TB culture as the gold standard,the positive rate of the simple group was 63.2%(79/125),which was significantly lower than that of the mild group(76.5%)and the severe group(91.5%),with statistical significance(P<0.05).There was no significant difference in the diagnostic specificity of the three methods in the three group(P>0.05).In the simple group,the diagnostic sensitivity and accuracy of Xpert MTB/RIF and T-SPOT.TB were higher than those of sputum smear,and the difference was statistically significant(P<0.05).In the mild and severe groups,the diagnostic sensitivity and accuracy of Xpert MTB/RIF were higher than those of sputum smear and T-SPOT.TB,and the difference was statistically significant(P<0.05).Conclusion Compared with simple tuberculosis,the positive detection rate of Mycobacterium tuberculosis in patients with type 2 diabetes is higher.For patients with tuberculosis and type 2 diabetes,Xpert MTB/RIF has good diagnostic sensiti
作者
侯永华
殷智晔
王永峰
马清艳
许娜
张焕
于丽微
HOU Yonghua;YIN Zhiye;WANG Yongfeng;MA Qingyan;XU Na;ZHANG Huan;YU Liwei(Department of Endocrinology,Hebei Chest Hospital,Shijiazhuang,Hebei,China,050041;The Third Department of Tumor,Hebei Chest Hospital,Shijiazhuang,Hebei,China,050041;The Fourth Department of Tuberculosis,Hebei Chest Hospital,Shijiazhuang,Hebei,China,050041;Women's Health Department of Qiaoxi District Maternal and Child Health Station,Shijiazhuang City,Shijiazhuang,Hebei,China,050000;The Third Tuberculosis Department of Hebei Chest Hospital,Shijiazhuang,Hebei,China,050041)
出处
《分子诊断与治疗杂志》
2023年第12期2066-2070,共5页
Journal of Molecular Diagnostics and Therapy
基金
河北省医学科学研究计划项目(20191005)。
