全血γ-干扰素释放试验联合GeneXpert结核分枝杆菌/利福平检测对肺结核的诊断效能  

Diagnostic Efficacy of Whole Blood Gamma-interferon Release Test Combined with GeneXpert Detection of Mycobacterium Tuberculosis/Rifampicin in Pulmonary Tuberculosis

作　　者：张海燕 缪家文 朱亮 宋戎 熊茜 李龙 李蕊 ZHANG Haiyan;MIAO Jiawen;ZHU Liang;SONG Rong;XIONG Qian;LI Long;LI Rui(Department of Clinical Laboratory,The Third People's Hospital of Zhenjiang,Zhenjiang 212000,Jiangsu,China)

机构地区：[1]镇江市第三人民医院检验科,江苏镇江212000

出　　处：《系统医学》2024年第18期72-75,共4页Systems Medicine

摘　　要：目的分析全血γ-干扰素释放试验联合全自动医用实时聚合酶链式反应系统(GeneXpert)结核分枝杆菌(mycobacterium tuberculosis,MTB)/利福平(rifampin,RIF)检测对肺结核的诊断效能。方法非随机选取镇江市第三人民医院于2022年2月—2024年2月收治的100例疑似肺结核患者为研究对象,均采取全血γ-干扰素释放试验检测、痰GeneXpert MTB/RIF检测,以固体培养结果作为金标准,分析单一及联合检测的诊断效能。结果100例疑似肺结核患者经临床诊断确诊为肺结核35例,检出率为35.00%(35/100)。联合检测的灵敏度为97.14%(34/35),高于γ-干扰素释放试验的74.29%(26/35)和GeneXpert MTB/RIF的77.14%(27/35),差异有统计学意义(χ^(2)=7.644,P<0.05)。联合与单一检测的特异度、阳性预测值、阴性预测值和准确度比较,差异无统计学意义(P均>0.05)。结论在肺结核的临床诊断中,全血γ-干扰素释放试验检测、GeneXpert MTB/RIF检测均有着良好的应用优势,两种检测方式联合诊断能够进一步提高诊断效能。Objective To analyze the diagnostic efficacy of whole blood gamma-interferon release test combined with automatic medical real-time polymerase chain reaction system(GeneXpert)for mycobacterium tuberculosis(MTB)/rifampin(RIF).Methods 100 patients with suspected pulmonary tuberculosis admitted to the Third People's Hospital of Zhenjiang City from February 2022 to February 2024 were non-randomly selected as the study objects.Whole blood gamma-interferon release assay and sputum GeneXpert MTB/RIF assay were used for detection.The results of solid culture were used as the gold standard to analyze the diagnostic efficacy of single and combined detection.Results Among 100 suspected patients with pulmonary tuberculosis,35 cases were clinically diagnosed with pulmonary tuberculosis,the detection rate was 35.00%(35/100).The sensitivity of combined detection was 97.14%(34/35),which was higher than 74.29%(26/35)of gamma-interferon release test and 77.14%(27/35)of GeneXpert MTB/RIF,the difference was statistically significant(χ^(2)=7.644,P<0.05).There were no significant differences in the specificity,positive predictive value,negative predictive value and accuracy between combination and single detection(all P>0.05).Conclusion In the clinical diagnosis of pulmonary tuberculosis,whole blood gamma-interferon release test and GeneXpert MTB/RIF detection have good application advantages,and the combined diagnosis of the two detection methods can further improve the diagnostic efficiency.

关 键 词：Γ-干扰素释放试验 GeneXpert结核分枝杆菌/利福平 肺结核 诊断效能 

分 类 号：R446.1[医药卫生—诊断学]