SAT-TB检测支气管肺泡灌洗液对涂阴肺结核的快速临床诊断价值  

Fast Diagnostic Value of SAT-TB for Smear-Negative Pulmonary Tuberculosis Using Bronchoalveolar Lavage Fluid

作　　者：许蕴怡[1] 蔡杏珊[1] 谭耀驹[1] 刘燕文[1] 周辉林[1] 曾少芳[1] 马品云 刘欣[1] 

机构地区：[1]广州市胸科医院,广东广州510095

出　　处：《现代医院》2018年第2期298-300,共3页Modern Hospitals

基　　金：广州市医药卫生科技项目(20161A010044)

摘　　要：目的探究结核分枝杆菌RNA恒温扩增实时荧光检测技术(SAT-TB)检测支气管肺泡灌洗液(BALF)对涂阴肺结核的诊断价值。方法对本院涂阴疑似肺结核患者进行筛查,共有80例患者进入最后分析,痰涂片连续3次阴性者进入研究,行培养法(Bactec MGIT 960)及SAT-TB检测,同时进行诊断。分别以培养法(BD960)及以临床诊断作为参考标准,计算SAT-TB法诊断涂阴肺结核的敏感度、特异度、阳性预测值及阴性预测值。结果以培养法(BD960)作为参考标准,SAT-TB诊断涂阴肺结核的敏感度为53.3%(8/15),特异度为88.2%(15/17),阳性预测值80.0%(8/10),阴性预测值68.1%(15/22)。以临床诊断作为参考标准,SAT-TB诊断涂阴肺结核的敏感度31.7%(20/63)、特异度88.2%(15/17)、阳性预测值91.0%(20/22)、阴性预测值25.9%(15/58)。SAT-TB的检测时间约2 h,快于培养法(BD960)的平均阳性报告时间14.1 d。结论 SAT-TB可通过检测BALF为涂阴肺结核患者提供一项敏感度相对于快速培养法(BD960法)较有优势的实验室辅助诊断方法。Objective To access the diagnostic value of SAT - TB （ simultaneous amplification and testing for Mycobacterium tuberculosis ） for smear - negative Pulmonary Tuberculosis （FrB） by testing bronchoalveocar lavage fluid （BALF）. Methods Form Sep. 2016 to Nov. 2016 in Guangzhou Municipal Hospital, we screened suspected PTB patients Of 80 PTB suspects included in the final analysis with 3 consecutive negative sputum smears, and obtained their BALF specimen by brochchoscopy. BALF was tested by both Bactec MGIT 960 culture and SAT - TB assay. The sensitivity, specificity, PPV and NPV for each diagnostic test were calculated using clinical diagnostic results as reference standard. Results Of 80 PTB suspects included, 15 were TB culture positive, 48 were PTB patients by slinical diagnosis with culture negative, 17 were non -TB patients. Using clinical diagnostic results as reference standard, the sensitivity, specificity, PPV and NPV of SAT - TB for smear - negative PTB testing BALF were 31.7%, 88.2%, 91.0% and 25.9%. The detection time of SAT - TB was around 2 hours, and shorter than 14.1 days needed by culture positive. Conclusion SAT - TB can be provide the superiority of sensitivity over the Bactec MGIT 960 and is a valuable diagnostic method.

关 键 词：结核 肺/诊断 支气管肺泡灌洗液 核酸扩增技术 

分 类 号：R521.04[医药卫生—内科学]