摘要
目的:对比支气管肺泡灌洗液(bronchoalveolar lavage fluid,BALF)结核分枝杆菌(MTB)/利福平(RIF)耐药实时荧光定量核酸扩增检测技术(Xpert MTB/RIF)和聚合酶链反应(PCR)-反向斑点杂交技术在涂阴肺结核诊断中的价值。方法:纳入2021年6月—2023年1月于江西省胸科医院接受治疗的肺结核患者共200例,所有患者均留取BALF送检,进行Xpert MTB/RIF、PCR-反向斑点杂交技术检测。以病理检查结果为金标准,统计确诊涂阴肺结核的占比情况,并计算Xpert MTB/RIF与PCR-反向斑点杂交技术两种检测方法的阳性率、与金标准结果的一致性,并评估两种检测方法对涂阴肺结核的诊断价值。结果:Xpert MTB/RIF检测涂阴肺结核的阳性率(76.50%)与PCR-反向斑点杂交技术(69.50%)比较,差异无统计学意义(χ^(2)=2.486,P=0.115)。200例肺结核患者中确诊为涂阴肺结核有137例,占比68.50%;Xpert MTB/RIF的符合率(94.89%)高于PCR-反向斑点杂交技术(74.45%),差异有统计学意义(P<0.05)。Xpert MTB/RIF诊断涂阴肺结核的敏感度、特异度、阳性预测值、阴性预测值、准确度均高于PCR-反向斑点杂交技术(P<0.05)。结论:Xpert MTB/RIF、PCR-反向斑点杂交技术均可用于涂阴肺结核诊断中,其中Xpert MTB/RIF的诊断价值更高,可辅助临床早期诊断筛查。
Objective:To compare the diagnostic value of Xpert Mycobacterium tuberculosis/Rifampicin(Xpert MTB/RIF)and polymerase chain reaction(PCR)-reverse dot blot hybridization technique in bronchoalveolar lavage fluid(BALF)in smear negtive pulmonary tuberculosis.Method:A total of 200 patients with pulmonary tuberculosis who received treatment in Jiangxi Chest Hospital from June 2021 to January 2023 were included.All patients were retained BALF for inspection,and they were detected by Xpert MTB/RIF and PCR-reverse dot blot hybridization technique.Using the results of pathological examination as the gold standard,the proportion of confirmed smear negtive pulmonary tuberculosis was counted,and the positive rates of Xpert MTB/RIF and PCRreverse dot blot hybridization technique were calculated,and the consistency with the gold standard results were calculated,and the diagnostic value of the two detection methods for smear negtive pulmonary tuberculosis were evaluated.Result:There was no significant difference in the positive rate of Xpert MTB/RIF(76.50%)in detecting smear negtive pulmonary tuberculosis compared with PCR-reverse dot blot hybridization technique(69.50%)(χ^(2)=2.486,P=0.115).Among 200 patients with pulmonary tuberculosis,137 cases(68.50%)were diagnosed as smear negtive pulmonary tuberculosis.The coincidence rate of Xpert MTB/RIF(94.89%)was higher than that of PCR-reverse dot blot hybridization technique(74.45%),the difference was statistically significant(P<0.05).The sensitivity,specificity,positive predictive value,negative predictive value and accuracy of Xpert MTB/RIF were higher than those of PCR-reverse dot blot hybridization technique(P<0.05).Conclusion:Both Xpert MTB/RIF and PCR-reverse dot blot hybridization technique can be used in the diagnosis of smear negtive pulmonary tuberculosis,among which Xpert MTB/RIF has a higher diagnostic value and can assist in early clinical diagnosis and screening.
作者
李邱宏
李赞华
陈艳玲
吴于青
陈思雨
LI Qiuhong;LI Zanhua;CHEN Yanling;WU Yuqing;CHEN Siyu(Department of Respiratory Medicine,Jiangxi Chest Hospital,Nanchang 330006,China;不详)
出处
《中国医学创新》
CAS
2024年第30期138-142,共5页
Medical Innovation of China
基金
江西省卫生健康委科技计划项目(202211258)。
