肺泡灌洗液效应T细胞斑点试验与RNA恒温扩增实时荧光检测对涂阴肺结核的诊断价值比较  

Diagnostic value comparison of effector T cell spot test of alveolar lavage fluid and RNA constant temperature amplification real-time fluorescence detection for smear-negative pulmonary tuberculosis

作　　者：黄健[1] 张志大[1] 李希玖 HUANG Jian;ZHANG Zhi-da;LI Xi-jiu(Department of Respiratory and Critical Care Medicine,Jiangxi Chest Hospital,Jiangxi Province,Nanchang 330006,China)

机构地区：[1]江西省胸科医院呼吸与危重症医学科,江西南昌330006

出　　处：《中国当代医药》2021年第26期216-219,共4页China Modern Medicine

基　　金：江西省卫生厅科技计划项目(20165512)。

摘　　要：目的比较肺泡灌洗液效应T细胞斑点试验(T-SPOT)与RNA恒温扩增实时荧光检测(SAT-TB)对涂阴肺结核的诊断价值。方法选取2019年1月至12月江西省胸科医院收治的80例疑似肺结核患者作为研究对象,按照痰涂片检验结果将其分为涂阳组(35例)与涂阴组(45例)。对涂阴组进行分子生物学检查,诊断为肺结核35例,诊断为非结核感染10例。使用结核感染T-SPOT检测涂阳组、涂阴组患者的肺泡灌洗液内效应T细胞,分析阳性率;收集涂阴组患者肺泡灌洗液,使用结核分枝杆菌SAT-TB检测肺泡灌洗液,与T-SPOT检测结果比较,分析肺泡灌洗液效应T细胞检测的诊断价值。结果T-SPOT检测下,涂阳组的阳性率(97.14%)高于涂阴组(75.56%),差异有统计学意义(P<0.05)。对涂阴组检测时,T-SPOT检测涂阴肺结核的阳性率(94.29%)高于SAT-TB检测(77.14%),差异有统计学意义(P<0.05)。T-SPOT检测的灵敏度(94.29%)、阴性预测值(NPV)(81.82%)均高于SAT-TB检测(77.14%、52.94%),差异有统计学意义(P<0.05)。两种检测方式的特异度均为90.00%。结论在对涂阴肺结核快速检测时,肺泡灌洗液T-SPOT的灵敏度较高,应用价值显著。Objective To compare the diagnostic value of effector T cell spot test(T-SPOT)of alveolar lavage fluid and RNA constant temperature amplification real-time fluorescence detection(STA-TB)for smear-negative pulmonary tuberculosis.Methods Eighty patients with suspected tuberculosis who were admitted to Jiangxi Chest Hospital from January to December 2019 were selected.Sputum smears showed that there were 35 cases in the smear-positive group,and 45 cases in the smear-negative group.The molecular biological examination of 45 cases in the smear-negative group showed that 35 cases were diagnosed as pulmonary tuberculosis,and 10 cases were diagnosed as non-tuberculosis infection.The effector T cells in the alveolar lavage fluid of the smear-positive and smear-negative group patients were detected by the tuberculosis infection effect T-SPOT,and the positive rate were analyzed.The alveolar lavage fluid were collected from the patients in the smear-negative group and alveolar lavage fluid were detected by using mycobacterium tuberculosis simultaneous amplification and testing for SAT-TB.The diagnostic value of the effect of alveolar lavage fluid T cell detection were analyzed by comparing results with T-SPOT detection.Results By the T-SPOT test,the positive rate of smear-positive group(97.14%)was higher than that in smear-negative group(75.56%),and the difference was statistically significant(P<0.05).When the smear-negative group was tested,the positive rate(94.29%)in the smear-negative tuberculosis group by T-SPOT was higher than that in SAT-TB test(77.14%),and the difference was statistically significant(P<0.05).By T-SPOT test,the sensitivity(94.29%),the positive predictive value(PPV)(97.06%)and the negative predictive value(NPV)(81.82%)were higher than those in SAT-TB(77.14%,96.43%,and 52.94%),and the differences were statistically significant(P<0.05).The specificity of the two detection methods were both 90.00%.Conclusion In the rapid detection of smear-negative pulmonary tuberculosis,the detection of effector T cells i

关 键 词：肺泡灌洗液 效应T细胞 涂阴肺结核 诊断 

分 类 号：R521[医药卫生—内科学]