支气管肺泡灌洗液Xpert MTB/RIF检测在涂阴肺结核诊断中的应用价值  

Application Value of Bronchoalveolar Lavage Fluid Xpert MTB/RIF in Diagnosis of Smear-negative Pulmonary Tuberculosis

作　　者：王利杰[1] Wang Lijie(Department of Respiratory and Critical Care Medicine,the Fourth Division Hospital of Xinjiang Production and Construction Corps,Yining 835000,Xinjiang Uygur Autonomous Region,China)

机构地区：[1]新疆生产建设兵团第四师医院呼吸与危重症医学科,新疆维吾尔自治区伊宁835000

出　　处：《中国社区医师》2024年第30期86-88,共3页Chinese Community Doctors

摘　　要：目的:分析支气管肺泡灌洗液结核分枝杆菌/利福平耐药实时荧光定量核酸扩增(Xpert MTB/RIF)检测在涂阴肺结核诊断中的应用价值。方法:选择2021年12月—2023年12月新疆生产建设兵团第四师医院收治的疑似涂阴肺结核患者80例作为研究对象,收集其支气管肺泡灌洗液,实施结核分枝杆菌液体培养药敏试验、抗酸染色涂片镜检、Xpert MTB/RIF检测。将结核分枝杆菌液体培养药敏试验结果作为“金标准”,比较抗酸染色涂片镜检、Xpert MTB/RIF检测诊断涂阴肺结核的效能。结果:结核分枝杆菌液体培养药敏试验显示,80例受试者确诊为涂阴肺结核44例。Xpert MTB/RIF检测诊断涂阴肺结核的准确率、灵敏度、阳性预测值、阴性预测值高于抗酸染色涂片镜检(P<0.05),抗酸染色涂片镜检、Xpert MTB/RIF检测诊断涂阴肺结核的特异度比较,差异无统计学意义(P>0.05)。结论:支气管肺泡灌洗液Xpert MTB/RIF检测在涂阴肺结核诊断中的应用价值较高,其诊断效能优于抗酸染色涂片镜检,且检测时间短,值得临床应用。Objective:To analyze the diagnostic value of Mycobacterium tuberculosis/Rifampicin resistance in bronchoalveolar la⁃vage fluid by real-time fluorescence quantitative nucleic acid amplification(Xpert MTB/RIF).Methods:A total of eighty patients with suspected vaginal tuberculosis treated in the Fourth Division Hospital of Xinjiang Production and Construction Corps from December 2021 to December 2023 were selected as the study objects.Bronchoalveolar lavage fluid was collected and mycobacte⁃rium tuberculosis liquid culture drug sensitivity test,acid-fast staining smear microscopy and Xpert MTB/RIF detection were per⁃formed.The results of liquid culture drug sensitivity test of Mycobacterium tuberculosis were used as the"gold standard"to com⁃pare the efficacy of acid-fast staining smear microscopy and Xpert MTB/RIF detection in the diagnosis of smeated negative pul⁃monary tuberculosis.Results:The liquid culture drug sensitivity test of Mycobacterium tuberculosis showed that 44 of the 80 sub⁃jects were diagnosed with smeared-negative pulmonary tuberculosis;the accuracy,sensitivity,positive predictive value and nega⁃tive predictive value of Xpert MTB/RIF were higher than those of acid-fast staining smear microscopy(P<0.05);there was no significant difference in the specificity between acid-fast staining smear microscopy and Xpert MTB/RIF detection in the diagno⁃sis of smear-negative pulmonary tuberculosis(P>0.05).Conclusion:Xpert MTB/RIF test of bronchoalveolar lavage fluid has high application value in the diagnosis of smear-negative pulmonary tuberculosis,and its diagnostic efficiency is better than acid-fast staining smear microscopy,and the detection time is short,which is worthy of clinical application.

关 键 词：涂阴肺结核 支气管肺泡灌洗液 Xpert MTB/RIF检测 

分 类 号：R521[医药卫生—内科学]