摘要
目的:观察结核分枝杆菌/利福平耐药实时荧光定量核酸扩增检测(GeneXpert MTB/RIF)联合外周血细胞分析用于痰涂片阴性可疑肺结核(TB)临床诊断的效果。方法:选取吉安市第一人民医院2022年10月—2023年9月收治的66例痰涂片阴性可疑TB患者。所有患者接受GeneXpert MTB/RIF检测及外周血细胞分析检测,对CD45^(+)CD3^(+)、CD4^(+)CD45^(+)及CD163^(+)进行分析,患者均经痰培养及菌种鉴定是否为肺结核。分析GeneXpert MTB/RIF检测及外周血细胞分析诊断痰涂片阴性可疑TB的价值。结果:66例患者中,36例可疑肺结核经痰培养、菌种鉴定确诊为TB患者(TB组),30例患者为非TB者(非TB组)。GeneXpert MTB/RIF检出30例阳性患者,检出率为83.33%。TB组CD45^(+)CD3^(+)低于非TB组,CD4^(+)CD45^(+)及CD163^(+)高于非TB组,差异均有统计学意义(P<0.05)。受试者操作特征(ROC)曲线分析结果显示,CD4^(+)CD45^(+)、CD45^(+)CD3^(+)及CD163^(+)联合GeneXpert MTB/RIF诊断痰涂片阴性TB的曲线下面积(AUC)高于单独检测,差异均有统计学意义(P<0.05)。GeneXpert MTB/RIF联合外周血细胞分析(CD4^(+)CD45^(+)、CD45^(+)CD3^(+)及CD163^(+))的敏感度为92.87%。结论:GeneXpert MTB/RIF检测及外周血细胞分析联合诊断痰涂片阴性可疑TB的价值显著,检出率较高。
Objective:To observe the effect of Mycobacterium tuberculosis/Rifampicin resistance real-time fluorescence quantitative nucleic acid amplification detection(GeneXpert MTB/RIF)combined with peripheral blood cell analysis for the clinical diagnosis of suspected pulmonary tuberculosis(TB)with sputum smear negative.Method:A total of 66 sputum smear negative suspected TB patients admitted to Ji’an First People's Hospital from October 2022 to September 2023 were selected.All patients underwent GeneXpert MTB/RIF test and peripheral blood cell analysis for CD45^(+)CD3^(+),CD4^(+)CD45^(+)and CD163^(+),and patients were identified by sputum culture and strain indentification for tuberculosis.The value of GeneXpert MTB/RIF test and peripheral blood cell analysis for diagnosing sputum smear negative suspected TB was analyzed.Result:Among 66 patients,36 patients with suspected pulmonary tuberculosis were diagnosed as TB patients(TB group)by sputum culture and strain identification,and 30 patients were non-TB patients(non-TB group).GeneXpert MTB/RIF was detected in 30 positive patients,with a detection rate of 83.33%.The CD45^(+)CD3^(+)of TB group was lower than that of non-TB group,CD4^(+)CD45^(+)and CD163^(+)were higher than those of non-TB group,the differences were statistically significant(P<0.05).The results of receiver operating characteristic(ROC)curve analysis showed that the area under the curve(AUC)of the combination of CD4^(+)CD45^(+),CD45^(+)CD3^(+),CD163^(+)and GeneXpert MTB/RIF detection was higher than that of single detection,the difference was statistically significant(P<0.05).The sensitivity of GeneXpert MTB/RIF combined with peripheral blood cell analysis(CD4^(+)CD45^(+),CD45^(+)CD3^(+)and CD163^(+))was 92.87%.Conclusion:GeneXpert MTB/RIF detection and peripheral blood cell analysis combined with sputum smear negative suspected TB has significant value and high detection rate.
作者
郭豆花
尹莹莹
李玥
GUO Douhua;YIN Yingying;LI Yue(Department of Clinical Laboratory,Ji'an First People's Hospital,Ji’an 343000,China;不详)
出处
《中国医学创新》
CAS
2024年第19期143-147,共5页
Medical Innovation of China
关键词
核酸扩增体系检测
肺结核
血细胞分析
诊断
痰涂片
Nucleic acid amplification detection
Tuberculosis
Blood cell analysis
Diagnosis
Sputum smear
