胸膜活检术联合胸腔积液GeneXpert MTB/RIF、ADA检测对结核性胸腔积液的诊断效能  

Diagnostic Efficacy of Pleural Biopsy Combined with Pleural Effusion GeneXpert MTB

作　　者：黄心蔚 吴格怡 黄壮伟 HUANG Xinwei;WU Geyi;HUANG Zhuangwei(The Second Affiliated Hospital of Guangdong Medical University,Zhanjiang 524000,China)

机构地区：[1]广东医科大学附属第二医院,广东湛江524000

出　　处：《中外医学研究》2024年第18期75-78,共4页CHINESE AND FOREIGN MEDICAL RESEARCH

基　　金：2021年度广东医科大学青年培育基金项目(GDMUQ2021043)。

摘　　要：目的:研究胸膜活检术联合胸腔积液GeneXpert结核分枝杆菌(mycobacterium tuberculosis,MTB)/利福平(Rifampin,RIF)、腺苷脱氨酶(adenosine deaminase,ADA)检测对结核性胸腔积液(tuberculous pleural effusion,TPE)的诊断效能。方法:以60例疑似TPE患者为研究对象,所有患者均行胸腔闭式引流术,抽取胸腔积液送检,行常规、ADA及GeneXpert MTB/RIF检测,部分患者经皮胸膜活检术或内科胸腔镜检查,取得病理结果。以综合参考标准(common reporting standard,CRS)为金标准,计算各检测方法单独及联合检测的诊断效能。结果:60例疑似TPE患者,经CRS检查确定结核性28例、非结核性32例。结核性患者胸腔积液ADA高于非结核性患者,差异有统计学意义(P<0.001)。与胸膜活检术、胸腔积液GeneXpert MTB/RIF、ADA单一检测比较,联合检测敏感度、准确度及阴性预测值更高,差异有统计学意义(P<0.05);而四者特异度、阳性预测值比较,差异无统计学意义(P>0.05)。结论:胸膜活检术、胸腔积液GeneXpert MTB/RIF、ADA联合检测对TPE具有较高的诊断效能。Objective:To study the diagnostic efficacy of pleural biopsy combined with pleural effusion GeneXpert mycobacterium tuberculosis(MTB)/Rifampin(RIF)and adenosine deaminase(ADA)detection in tuberculous pleural effusion.Method:Sixty patients with suspected TPE were selected as the study objects,all patients were underwent closed thoracic drainage,and pleural effusion was taken for examination,routine,ADA and GeneXpert MTB/RIF tests were performed.percutaneous pleural biopsy or medical thoracoscopy were performed in some patients,and pathological results were obtained.Taking the common reporting standard(CRS)as the gold standard,the diagnostic efficacy of each detection method alone and in combination were calculated.Result:In 60 patients with suspected TPE,28 cases of tuberculous and 32 cases of non-tuberculous were confirmed by CRS.The pleural effusion ADA of tuberculous patients was higher than that of non-tuberculous patients,and the difference was statistically significant(P<0.001).Compared with pleural biopsy,pleural effusion GeneXpert MTB/RIF and ADA single detection,the sensitivity,accuracy and negative predictive value of combined detection were higher,and the differences were statistically significant(P<0.05);but there were no significant differences in specificity and positive predictive value among the four(P>0.05).Conclusion:Combined detection of pleural biopsy,pleural effusion GeneXpert MTB/RIF and ADA has high diagnostic efficiency for TPE.

关 键 词：胸膜活检术 胸腔积液 胸腔积液腺苷脱氨酶 结核性胸腔积液 诊断效能 

分 类 号：R521.7[医药卫生—内科学]