胸水ADA、TB-DNA及BACTEC MGIT 960快速联合检测在结核性胸膜炎中的诊断价值  

Diagnostic Value of Rapid Combined Detection of Pleural effusion ADA,TB-DNA and BACTEC MGIT 960 in Tuberculous Pleurisy

作　　者：马志强 王霖 王晓燕 瞿春燕 高茜 许世涛 刘子龙 MA Zhi-qiang;WANG Lin;WANG Xiao-yan;QU Chu-yan;GAO Xi;XU Shi-tao;LIU Zi-long(Dept.of Laboratory,The Third People’s Hospital of Kunming,Kunming Yunnan 650301,China)

机构地区：[1]昆明市第三人民医院检验科,云南昆明650301

出　　处：《昆明医科大学学报》2020年第7期135-139,共5页Journal of Kunming Medical University

基　　金：昆明市科学技术局计划项目(昆科计字2017-1-S-14341);昆明市卫生科技人才培养暨“十百千”工程“千”工程后备人选(昆卫办【2019】12号);昆明市卫生和计划生育委员会2017年昆明市卫生科技人才暨“十百千”工程培养人选和内设研究机构(技术中心)建设项目(昆卫【2017年】26号)。

摘　　要：目的探讨ADA、TB-DNA及BACTEC MGIT 960快速联合检测在结核性胸膜炎中的应用价值。方法选取2017年10月至2019年10月昆明市第三人民医院收治的100例疑似结核性胸膜炎患者的胸水标本,采用ADA、TB-DNA及BACTEC MGIT 960快速联合检测,并与结核菌诊断金标准法BACTEC MGIT 960快速培养比较,分析三种方法联合检测的价值。结果ADA+TB-DNA+BACTEC MGIT 960联合检测结果阳性率为77%,敏感度为88.9%、特异度为92.8%,AUC为0.95;BACTEC MGIT 960金标准法检测结果阳性率为20%,敏感度为90.9%,特异度为97.6%,AUC为0.83;其它检测ADA+TB-DNA及ADA+BACTEC MGIT 960结果阳性率分别为57%、52%,敏感度及特异度分别为87.9%、90.4%和88.7%、93.0%,AUC分别为0.82和0.87。联合检测阳性率均显著高于金标准法和其它检测(P<0.05)。结论在疑似结核性胸膜炎患者的实验室诊断中,ADA、TB-DNA及BACTEC MGIT 960快速联合检测的结果准确性、阳性率高,对结核性胸膜炎的诊断有重要的临床价值。Objective To investigates the application of rapid combined detection of ADA,TB-DNA and BACTEC MGIT 960 in the early diagnosis of tuberculous pleurisy.Methods We collected 100 cases of pleural effusion specimens from patients with tuberculous pleurisy in The Third People’s Hospital of Kunming from Oct2017-Oct 2019.We simultaneously used ADA,TB-DNA and BACTEC MGIT 960 for rapid joint detection,and compared the results with the gold standard BACTEC MGIT 960 culture of bacteriology of tuberculosis.Then we analyzed the positive rate and efficacy of ADA,TB-DNA and BACTEC MGIT 960 rapid combined detection and three simple tests and their combined detection.Results The positive rate of ADA+TB-DNA+BACTEC MGIT960 combined test was 77%,the sensitivity was 88.9%,the specificity was92.8%,and the AUC was 0.95;The BACTEC MGIT 960 gold standard test positive rate of 20%,the sensitivity of 90.9%,the specificity of97.6%,and the AUC was 0.83;The positive rates of other tests for ADA+TB-DNA and ADA+BACTEC MGIT 960 were 57%and 52%,The sensitivity and specificity were 87.9%、90.4%and 88.7%、93.0%,respectively,and the AUC were 0.82 and 0.87.The positive rate of the combined test is significantly higher than the gold standard method and other tests(P<0.05).Conclusions In laboratory diagnosis of suspected tuberculous pleurisy,the results of rapid joint detection in ADA,TB-DNA and BACTEC MGIT 960 are accurated and have high positive rate.It has important clinical application value in the diagnosis of tuberculous pleurisy.

关 键 词：腺苷脱氨酶 结核菌脱氧核糖核酸 结核菌鉴定药敏培养系统 快速联合检测 结核性胸膜炎 

分 类 号：R446.1[医药卫生—诊断学]