宏基因组二代测序技术联合X-pert在肺结核中的诊断价值分析  

Analysis of diagnostic value of metagenomic second-generation sequencing technology combined with X-pert in pulmonary tuberculosis

作　　者：曾中华 盛翠霞 ZENG Zhonghua;SHENG Cuixia(Department of Respiratory and Critical Care,First People's Hospital of Fuzhou,Jiangxi Province,Fuzhou344100,China)

机构地区：[1]江西省抚州市第一人民医院呼吸与危重症科,江西抚州344100

出　　处：《中国当代医药》2024年第26期26-29,34,共5页China Modern Medicine

基　　金：江西省卫生健康委科技计划项目(SKJP220200782)。

摘　　要：目的探讨宏基因组二代测序技术(mNGS)联合X-pert在肺结核中的诊断价值。方法选取2022年2月至2023年12月抚州市第一人民医院收治的98例疑似肺结核患者作为研究对象,均行mNGS、X-pert检查,以临床诊断结果为准,分析X-pert、mNGS单独与联合诊断肺结核的价值。结果98例疑似患者经临床确诊为肺结核50例(51.02%),非肺结核48例(48.98%);mNGS联合X-pert诊断肺结核的特异度、阳性预测值与mNGS相同,均为100.00%;mNGS联合X-pert诊断准确度为87.76%,敏感度为76.00%,高于X-pert的72.45%、52.00%和mNGS的79.59%、60.00%,差异有统计学意义(P<0.017);X-pert、mNGS联合诊断肺结核与临床诊断存在良好的一致性(Kappa=0.756,P<0.05),而单一检测结果与临床诊断的一致性不佳(Kappa=0.454、0.595,P<0.05)。结论mNGS联合X-pert诊断可提高肺结核检出率,值得临床推广。Objective To evaluate the diagnostic value of metagenomics next-generation sequencing(mNGS)combined with X-pert in pulmonary tuberculosis.Methods A total of 98 patients with suspected pulmonary tuberculosis admitted to First People's Hospital of Fuzhou from February 2022 to December 2023 were selected as the study objects.mNGS and X-pert were all examined,and the value of single and combined diagnosis of pulmonary tuberculosis by X-pert and mNGS was analyzed based on clinical diagnosis results.Results Of the 98 suspected patients,50 cases(51.02%)were clinically diagnosed as pulmonary tuberculosis,48 cases(48.98%)were non-pulmonary tuberculosis.The specificity and positive predictive value of mNGS combined with X-pert in the diagnosis of pulmonary tuberculosis were the same as those of mNGS,both being 100.00%.The diagnostic accuracy and sensitivity of mNGS combined with X-pert were 87.76%and 76.00%,which were higher than those of X-pert(72.45%and 52.00%)and mNGS(79.59%and 60.00%),and the differences were statistically significant(P<0.017).There was good consistency between the combined diagnosis of pulmonary tuberculosis with X-pert and mNGS(Kappa=0.756,P<0.05),while the consistency between single detection and clinical diagnosis was poor(Kappa=0.454,0.595,P<0.05).Conclusion mNGS combined with X-pert can improve the detection rate of pulmonary tuberculosis,which is worthy of clinical promotion.

关 键 词：肺结核 宏基因组二代测序技术 X-pert 一致性 

分 类 号：R521[医药卫生—内科学]