四种不同的检测技术对活动性肺结核诊断的效果评估  

Evaluation of the effects of four different testing techniques for the diagnosis of active tuberculosis

作　　者：曹烜标 王燕茹 洪丽娟 黄莉苹 CAO Xuanbiao;WANG Yanru;HONG Lijuan;HUANG Liping(Department of Clinical Laboratory,Chaoyang Hospital,Zhangzhou,Fujian 363005,China)

机构地区：[1]福建省漳州市朝阳医院检验科,福建漳州363005

出　　处：《检验医学与临床》2024年第S02期61-65,共5页Laboratory Medicine and Clinic

摘　　要：目的研究BD960结核液体培养法、实时荧光定量PCR法(溶解曲线法)、抗酸染色、结核感染T细胞检测(T-SPOT.TB)对活动性肺结核患者诊断的效果评价。方法分析该院2021年4月-2022年4月住院及门诊104例肺结核患者以及50例随机对照,按照痰涂片找抗酸菌的结果将研究对象分为痰阳组和痰阴组,以临床最终诊断为标准,分析其MGIT960结核液体培养系统、实时荧光PCR(溶解曲线法)、抗酸染色、结核感染T细胞检测(T-SPOT.TB)对活动性肺结核诊断的效果评估。结果结核液体培养法对活动性结核的诊断效果最好,其灵敏度、特异度、准确度分别99.04%,100%,99.35%。痰涂片阳性组中,结核液体培养对活动性结核的诊断效果最好,其灵敏度、特异度均为100%。痰涂片阴性组中结核液体培养对活动性结核的诊断效果最好,其灵敏度、特异度分别为98.04%、100%。在活动性肺结核中预测抗酸染色阳性结果的ESAT6抗原、CFP10抗原最佳阈值为28.5、36.5,其灵敏度为79.6%、70.4%,特异度为80%、90%。结论MGIT960结核液体培养法对活动性肺结核的辅助诊断效果最好,在活动性肺结核患者中T-SPOT.TB结果对初筛抗酸染色阳性结果具有一定的预测价值。Objective To study the liquid culture method of BD960 tuberculosis,real-time quantitative PCR(dissolution curve method),acid-fast staining,tuberculosis-infected T cell detection(T-SPOT.TB)on the diagnosis of patients with active tuberculosis.Methods A total of 104 inpatient and outpatient patients with pulmonary tuberculosis and 50 randomized controlled patients in the hospital from April 2021 to April 2022 were analyzed,and the research subjects were divided into sputum-yang group and sputum-yin group according to the yin and yang of sputum smear to find acid-fast bacteria,and the MGIT960 tuberculosis liquid culture system,real-time fluorescence PCR(dissolution curve method),acid-fast staining,and tuberculosis infection T-cell detection(T-SPOT.TB)on the diagnosis of active tuberculosis.Results Tuberculosis liquid culture had the best diagnostic effect on active tuberculosis,with sensitivity,specificity,and accuracy of 99.04%,100%and 99.35%,respectively.In the sputum smear-positive group,tuberculosis liquid culture had the best diagnostic effect on active tuberculosis,with sensitivity and specificity of 100%,respectively.In the sputum smear-negative group,the sputum smear negative group had the best diagnostic effect on active tuberculosis,with sensitivity and specificity of 98.04%and 100%,respectively.The optimal thresholds for predicting positive acid-fast staining results for ESAT6 antigen and CFP10 antigen in active pulmonary tuberculosis were 28.5 and 36.5,with sensitivities of 79.6%and 70.4%,specificity of 80%and 90%.Conclusion MGIT960 liquid culture method has the best effect on the auxiliary diagnosis of active pulmonary tuberculosis,and the results of T-SPOT.TB have certain predictive value for the positive results of acid-fast staining in the initial screening in patients with active pulmonary tuberculosis.

关 键 词：活动性肺结核 MGIT960结核液体培养 外周血结核感染T细胞检测 实时荧光PCR溶解曲线法 

分 类 号：R521[医药卫生—内科学]