肺泡灌洗液结核分枝杆菌RNA恒温扩增实时检测联合Xpert结核分枝杆菌/利福平耐药检测诊断肺结核价值的研究  

Study on the value of bronchoalveolar lavage fluid testing for Mycobacterium tuberculosis and simultaneous amplification combined with GeneXpert Mycobacterium tuberculosis/Rifampicin in the diagnosis of pulmonary tuberculosis

作　　者：洪炳 刘燕 李希玖 钟益锴 黄健[1] HONG Bing;LIU Yan;LI Xijiu;ZHONG Yikai;HUANG Jian(The First Department of Respiratory Crisis,Jiangxi Chest Hospital,Jiangxi Province,Nanchang 330000,China;Department of General Practice,Fenghuangzhou Community Health Service Center of Honggutan District in Nanchang City,Jiangxi Province,Nanchang 330038,China)

机构地区：[1]江西省胸科医院呼危一科,江西南昌330000 [2]南昌市红谷滩区凤凰洲社区卫生服务中心全科,江西南昌330038

出　　处：《中国当代医药》2025年第7期15-18,共4页China Modern Medicine

基　　金：江西省卫生健康委科技计划项目(202211254)。

摘　　要：目的分析肺泡灌洗液结核分枝杆菌RNA恒温扩增实时检测(TB-SAT)联合Xpert结核分枝杆菌/利福平耐药检测(Xpert MTB/RIF)诊断肺结核的价值。方法选取2021年2月至2023年2月江西省胸科医院收治的60例疑似肺结核患者作为研究对象,采用受试者工作特征(ROC)曲线分析单一TB-SAT、Xpert MTB/RIF与二者联合检测的诊断效能。结果60例疑似肺结核患者中,18例培养阳性,34例为培养阴性,经过临床诊断的肺结核患者共52例,8例为其他疾病。52例确诊患者中,TB-SAT阳性符合率为57.69%,Xpert MTB/RIF阳性符合率为69.23%,TB-SAT联合Xpert MTB/RIF阳性符合率为92.31%,同时阳性25例。联合检测的诊断灵敏度为92.31%,特异度为87.50%,AUC为0.842,95%CI:0.786~0.893,约登指数为0.779,均高于两种检查方法的单一检测结果。结论针对疑似肺结核患者,联合应用TB-SAT与Xpert MTB/RIF诊断价值较高,建议推广。Objective To analyze the value of bronchoalveolar lavage fluid testing for Mycobacterium tuberculosis and simultaneous amplification(TB-SAT)combined with GeneXpert Mycobacterium tuberculosis/Rifampicin(Xpert MTB/RIF)in the diagnosis of pulmonary tuberculosis.Methods A total of 60 patients with suspected pulmonary tuberculosis admitted to Jiangxi Chest Hospital from February 2021 to February 2023 were selected as study subjects.The receiver operating characteristic(ROC)curve was used to analyze the diagnostic efficacy of single TB-SAT,Xpert MTB/RIF and their combination.Results Among 60 suspected pulmonary tuberculosis patients,18 were culture positive and 34 were culture negative.A total of 52 patients were clinically diagnosed as pulmonary tuberculosis and 8 patients were diagnosed as other diseases.Among 52 confirmed patients,the positive coincidence rate of TB-SAT was 57.69%,the positive coincidence rate of Xpert MTB/RIF was 69.23%,the positive coincidence rate of TB-SAT combined with Xpert MTB/RIF was 92.31%,and 25 cases were positive at the same time.The diagnostic sensitivity of combined detection was 92.31%,the specificity was 87.50%,the AUC was 0.842,95%CI:0.786-0.893,and the Youden index was 0.779,which were higher than the single detection results of the two methods.Conclusion For suspected pulmonary tuberculosis patients,the combination of TB-SAT and Xpert MTB/RIF has a high diagnostic value,and it is recommended to be popularized.

关 键 词：肺结核 肺泡灌洗 结核分枝杆菌RNA恒温扩增实时检测 Xpert结核分枝杆菌/利福平耐药检测 

分 类 号：R521[医药卫生—内科学]