5种检测方法对涂阴肺结核诊断价值的探讨  

Diagnosis value of 5 detection methods for smear negative pulmonary tuberculosis

作　　者：彭宁[1] 朱晔晶[1] 蔡莎莎[1] 段达荣[1] 张虹[1] PENG Ning;ZHU Ye- jing;CAI Sha- sha;DUAN Da- rong;ZHANG Hong(The First People＇s Hospital of Taizhou , Taizhou , Zhefiang 318020, China)

机构地区：[1]台州市第一人民医院,浙江台州318020

出　　处：《中国卫生检验杂志》2018年第7期798-800,共3页Chinese Journal of Health Laboratory Technology

基　　金：浙江省黄岩科技局资助项目(2016044-4)

摘　　要：目的评价5种检测方法对涂阴肺结核病的诊断价值。方法用利福平耐药实时荧光定量核酸扩增检测技术(Xpert MTB/RIF)、结核感染T细胞检测(T-SPOT)、MGIT液体培养、腺苷脱氨酶(ADA)和结核抗体检测法对涂阴肺结核进行检测,并对其结果进行比较。结果涂阴肺结核患者T-SPOT、ADA、Xpert MTB/RIF阳性率、MGIT液体培养阳性率、结核抗体阳性率均明显高于肺炎组、肺癌组及对照组,差异有统计学意义(P<0.05)。T-SPOT诊断涂阴肺结核的敏感度(82.2%)和特异度(92.4%)均较高,Xpert MTB/RIF、结核培养诊断涂阴肺结核的特异度较高(97.5%、100.0%),ADA、结核抗体诊断涂阴肺结核的敏感度较高(85.9%、84.4%)。结论联合应用Xpert MTB/RIF、T-SPOT、MGIT液体培养、ADA和结核抗体均能提高涂阴肺结核的阳性检出率,减少漏诊和误诊率。Objective To evaluate the value of 5 detection methods for the diagnosis of smear negative pulmonary tuberculosis.Methods Negative smear tuberculosis was detected with Xpert MTB/RIF,tuberculosis-infected T-cell detection（T-SPOT）,MGIT liquid culture,adenosine deaminase（ADA）,and tuberculosis antibody assay,and the results were compared.Results The positive rates of Xpert MTB/RIF,T-SPOT,MGIT liquid culture,ADA and tuberculosis antibody test were obviously higher in the smear negative pulmonary tuberculosis group than that in the lung cancer group,pneumonia group and control group,with the differences statistically significant（P 0.05）.Sensitivity（82.2%）and specificity（92.4%）of T-SPOT in diagnosis of smear negative pulmonary tuberculosis were higher.The specificity of Xpert MTB/RIF and MGIT liquid culture in diagnosis smear negative pulmonary tuberculosis was high（97.5%,100.0%）.Sensitivity of ADA and tuberculosis antibody test in diagnosis smear negative pulmonary tuberculosis was high（85.9%,84.4%）.Conclusion The combined detection of Xpert MTB/RIF,T-SPOT,MGIT liquid culture,ADA and tuberculosis antibodies can increase the positive detection rate of smear-negative pulmonary tuberculosis and reduce missed diagnosis and misdiagnosis.

关 键 词：涂阴肺结核 利福平耐药实时荧光定量核酸扩增检测技术 结核感染T细胞检测 MGIT液体培养 

分 类 号：R521[医药卫生—内科学]