肺泡灌洗液结核RNA及XPERT-MTB/RIF联合检测对菌阴肺结核的诊断价值  

Diagnostic Value of Pulmonary Tuberculosis RNA and XPERT-MTB/RIFCombined Detection in Alveolar Lavage Fluid

作　　者：李孝军[1] 林红梅 何涛 陈菊蓉 Li Xiaojun(Department of Respiratory and Critical Care Medicine,Zhongjiang County People’s Hospital,Deyang Sichuan 618300)

机构地区：[1]四川省中江县人民医院呼吸与危重症医学科,四川德阳618300

出　　处：《黑龙江医药》2025年第1期44-47,共4页Heilongjiang Medicine journal

基　　金：德阳市科技计划项目(编号:2022SCZ106)。

摘　　要：目的:探讨菌阴肺结核采用肺泡灌洗液结核RNA(TB-RNA)及XPERT-MTB/RIF联合检测诊断的价值。方法:选择2022年4月—2024年4月四川省中江县人民医院收治的50例初治菌阴肺结核患者作为观察组,选择同期我院收治的50例初治菌阳肺结核患者作为对照组。两组均进行肺泡灌洗液TB-RNA及XPERT-MTB/RIF单独及联合检测诊断,比较两组的TB-RNA、XPERT-MTB/RIF的阳性检出率,并以痰涂片查抗酸杆菌阳性结果为准,评估TB-RNA、XPERT-MTB/RIF单独及联合诊断初治菌阴肺结核的效能。结果:观察组TB-RNA、XPERT-MTB/RIF阳性率均低于对照组(P<0.05);痰涂片抗酸杆菌检查结果显示,初治菌阴肺结核患者中阳性19例,阴性31例;肺泡灌洗液TB-RNA检测诊断菌阴肺结核的准确性、敏感性、特异性分别为86.00%、100.00%、81.58%;XPERT-MTB/RIF检测诊断菌阴肺结核的准确性、敏感性、特异性分别为96.00%、100.00%、93.94%,两者联合检测诊断菌阴肺结核的准确性、敏感性、特异性分别为98.00%、100.00%、96.88%;联合和单一诊断的敏感性相同,联合诊断和XPERT-MTB/RIF诊断的准确性、特异性均高于TB-RNA诊断(P<0.05),联合诊断和XPERT-MTB/RIF诊断的准确性和特异性相比无明显差异(P>0.05)。结论:在菌阴肺结核的诊断中,肺泡灌洗液XPERT-MTB/RIF单一检查与联合TB-RNA检查的诊断性均高于TB-RNA检查,临床可根据实际需要选择合适的诊断方式,确保菌阴肺结核的诊断效能,为其后续治疗提供参考。Objective:To investigate the diagnostic value of pulmonary tuberculosis by pulmonary alveolar lavage fluid tuberculosis RNA(TB-RNA)and XPERT-MTB/RIF combined detection.Methods:50 cases of newly treated positive pulmonary tuberculosis in our hospital from April 2022 to April 2024 were selected as the observation group,and 50 cases of newly treated positive pulmonary tuberculosis in our hospital during the same period were selected as the control group. TB-RNA and XPERT-MTB/RIF in alveolar lavage fluid were detected separately and jointly in both groups. The positive detection rates of TB-RNA and XPERT-MTB/RIF in the two groups were compared,and the positive results of acid-fast bacilli detected by sputum smear were used as the standard. To evaluate the efficacy of TB-RNA and XPERT-MTB/RIF alone and in combination in the diagnosis of primary negative pulmonary tuberculosis.Results: The positive rates of TB-RNA and XPERT-MTB/RIF in observation group were lower than those in control group ( P <0.05). The results of acidobacter test on sputum smear showed that 19 cases were positive and 31 cases were negative. The accuracy,sensitivity and specificity of TB-RNA in the diagnosis of bacterial negative pulmonary tuberculosis were 86.00%,100.00% and 81.58%,respectively. The accuracy,sensitivity and specificity of XPERT-MTB/RIF were 96.00%,100.00% and 93.94%,respectively. The accuracy,sensitivity and specificity of Xpert-MTB /RIF combined detection were 98.00%,100.00% and 96.88%,respectively. The sensitivity of combined diagnosis and single diagnosis was the same,the accuracy and specificity of combined diagnosis and XPERT-MTB/RIF diagnosis were higher than that of TB-RNA diagnosis ( P <0.05),and there was no significant difference in the accuracy and specificity of combined diagnosis and XPERT-MTB/RIF diagnosis ( P >0.05).Conclusion: In the diagnosis of bacterial negative pulmonary tuberculosis,XPERT-MTB/RIF single examination combined with TB-RNA examination is more diagnostic than that of TB-RNA examination. The appropri

关 键 词：肺泡灌洗液 结核RNA XPERT-MTB/RIF 菌阴肺结核 诊断价值 

分 类 号：R521[医药卫生—内科学]