肺泡灌洗液TB-SAT快速诊断涂阴肺结核价值的研究  

Study on the value of pulmonary alveolar lavage fluid TB-SAT in rapid diagnosis of smeared negative pulmonary tuberculosis

作　　者：洪炳 李希玖 钟益锴 张志大[1] 黄健[1] 裴静璇 HONG Bing;LI Xijiu;ZHONG Yikai;ZHANG Zhida;HUANG Jian;PEI Jingxuan(The First Department of Respiratory Critical Care,Jiangxi Chest Hospital,Jiangxi Province,Nanchang330000,China;Department of Clinical Laboratory,Jiangxi Chest Hospital,Jiangxi Province,Nanchang330000,China)

机构地区：[1]江西省胸科医院呼危一科,江西南昌330000 [2]江西省胸科医院检验科,江西南昌330000

出　　处：《中国当代医药》2023年第10期82-85,共4页China Modern Medicine

基　　金：江西省卫生健康委科技计划项目(202211254)。

摘　　要：目的探究肺泡灌洗液结核分枝杆菌RNA恒温扩增荧光实时检测技术(TB-SAT)诊断涂阴肺结核诊断的价值。方法选取2022年1月至7月江西省胸科医院收治的60例疑似肺结核患者,将综合诊断结果(符合肺结核基层诊疗指南)设为金标准,进行肺泡灌洗液TB-SAT,分析价值。结果60例患者中,46例患者诊断为肺结核,剩余14例为其他疾病。在46例经金标准诊断为肺结核的患者中,支气管肺泡灌洗液(BALF)抗酸染色诊断9例为肺结核患者;BALF结核菌培养诊断14例为肺结核患者;BALF聚合酶链式反应(PCR)检测诊断21例为肺结核患者;BALF TB-SAT诊断30例为肺结核患者。BALF抗酸染色诊断结果:敏感度为19.57%(9/46)、特异度为57.14%(8/14)、准确度为28.33%(17/60);BALF结核菌培养诊断结果:敏感度为30.43%(14/46)、特异度为78.57%(11/14)、准确度为41.67%(25/60);BALF PCR诊断结果:敏感度为45.65%(21/46)、特异度为64.29%(9/14)、准确度为50.00%(30/60);BALF TB-SAT诊断结果:敏感度为65.22%(30/46)、特异度为92.86%(13/14)、准确度为71.67%(43/60)。BALF TB-SAT诊断结果敏感度、准确度高于其他检测方法,差异有统计学意义(P<0.05);不同检测方法的特异度比较,差异无统计学意义(P>0.05)。结论诊断涂阴肺结核患者时,利用肺泡灌洗液TB-SAT具有较高价值,临床效果显著。Objective To explore the value of simultaneous amplification of Mycobacterium tuberculosis RNA in tubercle bacillus-simultaneous amplification and testing(TB-SAT)in the diagnosis of smear-negative pulmonary tuberculosis.Methods A total of 60 patients with suspected pulmonary tuberculosis admitted to Jiangxi Provincial Chest Hospital from January to July 2022 were selected.The comprehensive diagnosis results(in line with the guidelines for primary diagnosis and treatment of pulmonary tuberculosis)were set as the gold standard,and the TB-SAT of alveolar lavage fluid was performed,and the value was analyzed.Results Among the 60 patients,46 patients were diagnosed as pulmonary tuberculosis,and the remaining 14 patients were diagnosed as other diseases.Among the 46 patients diagnosed with pulmonary tuberculosis by the gold standard,9 patients were diagnosed as pulmonary tuberculosis by acid-fast staining of bronchoalveolar lavage fluid(BALF).Fourteen patients were diagnosed as pulmonary tuberculosis by culture of BALF.Twenty-one cases of pulmonary tuberculosis were diagnosed by BALF polymerase chain reaction(PCR).Thirty patients were diagnosed as pulmonary tuberculosis by BALF TB-SAT.The sensitivity,specificity and accuracy of BALF acid-fast staining were 19.57%(9/46),57.14%(8/14)and 28.33%(17/60),respectively.The sensitivity,specificity and accuracy of BALF culture were 30.43%(14/46),78.57%(11/14)and 41.67%(25/60),respectively.The sensitivity,specificity and accuracy of BALF PCR diagnosis were 45.65%(21/46),64.29%(9/14)and 50.00%(30/60),respectively.The sensitivity,specificity and accuracy of BALF TB-SAT were 65.22%(30/46),92.86%(13/14)and 71.67%(43/60),respectively.The sensitivity and accuracy of BALF TB-SAT were higher than those of other detection methods,with statistically significant differences(P<0.05).There were no significant differences in the specificity of different detection methods(P>0.05).Conclusion In the diagnosis of smear-negative pulmonary tuberculosis,the use of bronchoalveolar lavage fluid TB-SAT

关 键 词：涂阴肺结核 肺泡灌洗液TB-SAT 诊断效果 诊断方法 聚合酶链式反应 

分 类 号：R446[医药卫生—诊断学]