2种方法检测与痰涂片阴性肺结核患者诊断效能的关系研究  

Study on the relationship between two methods and the diagnostic efficiency of sputum smear negative pulmonary tuberculosis patients

作　　者：黄琦[1] 吴婷婷 孔晓明[1] 周翔[1] HUANG Qi;WU Tingting;KONG Xiaoming;ZHOU Xiang(Department of Laboratory Medicine,Liyang People’s Hospital,Liyang,213300,China)

机构地区：[1]溧阳市人民医院检验科,江苏溧阳213300

出　　处：《临床血液学杂志》2021年第8期568-570,575,共4页Journal of Clinical Hematology

基　　金：常州市科研计划项目(No:WZ201730)。

摘　　要：目的:研究利福平耐药实时荧光定量核酸扩增技术(Xpert MTB/RIF)结合结核感染T细胞试验(T-SPOT)2种方法检测与痰涂片阴性肺结核患者诊断效能的关系。方法:收集2020年1月—2020年10月就诊的呼吸系统疾病患者212例,分为对照组(102例)和结核组(110例)。对所有患者进行Xpert MTB/RIF以及T-SPOT检查,分析2种检测方法对结核病以及涂片阴性肺结核的诊断效能之间的差异。结果:采用Xpert MTB/RIF、T-SPOT、涂片及培养4种方法同时对结核组和对照组进行检测,不同方法结果比较差异有统计学意义(P<0.001);Xpert MTB/RIF、T-SPOT、联合检测的灵敏度分别为59.09%、64.49%及83.46%。联合检测诊断对肺结核患者的诊断灵敏度显著高于单独检测(P<0.05);通过联合诊断效能分析,联合诊断对涂阴肺结核患者的诊断灵敏度显著高于单独检测。结论:Xpert MTB/RIF结合T-SPOT检测对于痰涂片阴性肺结核患者的诊断灵敏度高,建议临床应用推广。Objective:To study the relationship between xpert MTB/RIF combined with T-SPOT detection and diagnostic efficiency of smear negative pulmonary tuberculosis patients.Methods:A total of 212 patients with respiratory diseases hospitalized in the respiratory department of our hospital from January 2020 to October 2020 were collected and divided into control group(n=102)and tuberculosis group(n=110).All patients were examined by xpert MTB/RIF and T-SPOT respectively to analyze the difference between the two diagnostic methods in the diagnosis of tuberculosis and smear negative tuberculosis.Results:The sensitivity of xpert MTB/RIF,T-SPOT,smear and culture were 59.09%,64.49%and 83.46%,respectively.The diagnostic sensitivity of combined detection in patients with pulmonary tuberculosis was significantly higher than that of single detection(P<0.05).The diagnostic sensitivity of combined diagnosis in patients with smear negative pulmonary tuberculosis was significantly higher than that of single detection.Conclusion:The sensitivity of xpert MTB/RIF combined with T-SPOT detection in the diagnosis of smear negative pulmonary tuberculosis patients is significantly increased,and it is recommended to be popularized in clinical practice.

关 键 词：荧光定量核酸扩增技术 结核感染T细胞试验 肺结核 联合诊断 

分 类 号：R521[医药卫生—内科学]