摘要
目的探讨肺泡灌洗液(BALF)结核和利福平耐药基因实时荧光定量核酸扩增(Xpert MTB/RIF)、BD-960快速培养、罗氏培养联合诊断菌阴肺结核(BGT)的价值。方法选取2019年1月—2022年8月原荆州市胸科医院疑似BGT患者210例,均送检BALF Xpert MTB/RIF、BD-960快速培养和罗氏培养。根据临床病史、影像学和支气管镜检查等临床诊断结果将210例患者分为BGT组和非BGT组。以临床诊断为标准,评估BALF Xpert MTB/RIF、BD-960快速培养和罗氏培养联合诊断BGT的效能。结果210例疑似BGT患者经临床诊断确诊BGT 136例,非BGT 74例。以临床诊断为标准,罗氏培养、BD-960快速培养、BALF Xpert MTB/RIF诊断BGT的敏感性分别为56.62%、58.82%、67.64%,特异性分别为91.89%、87.84%、94.59%,准确性分别为69.05%、69.05%、77.14%,阳性预测值分别为92.77%、89.89%、95.83%,阴性预测值分别为53.54%、53.72%、61.40%,Kappa值分别为0.417、0.426、0.554。罗氏培养、BD-960快速培养、BALF Xpert MTB/RIF联合诊断BGT的敏感性为76.47%,特异性为97.30%,准确性为83.81%,阳性预测值为98.11%,阴性预测值为69.23%,Kappa值为0.675。结论BALF Xpert MTB/RIF、BD-960快速培养、罗氏培养联合可提高BGT的诊断准确率。
Objective To investigate the diagnostic value of Xpert Mycobacterium tuberculosis/rifampicin(Xpert MTB/RIF)combined with BD-960 rapid culture and Roche culture in bronchoalveolar lavage fluid(BALF)for bacteriological negative pulmonary tuberculosis(BGT).Methods A total of 210 patients with suspected BGT treated at former Jingzhou Chest Hospital were enrolled between January 2019 and August 2022,and BALF Xpert MTB/RIF,BD-960 rapid culture and Roche culture were performed.According to clinical medical history and clinical diagnosis results(imaging,bronchoscopy),there were 136 cases with BGT and 74 cases without BGT.Taking clinical diagnosis as the golden standard,the efficiency of BALF Xpert MTB/RIF combined with BD-960 rapid culture and Roche culture in the diagnosis of BGT was evaluated.Results Among the 210 patients with suspected BGT,clinical diagnosis showed that there were 136 cases with BGT and 74 cases without BGT.Taking clinical diagnosis as the golden standard,the sensitivities,specificities,accuracies,positive predictive values,negative predictive values and Kappa values of Roche culture,BD-960 rapid culture and BALF Xpert MTB/RIF and combined determination in the diagnosis of BGT were 56.62%,91.89%,69.05%,92.77%,53.54%,0.417;58.82%,87.84%,69.05%,89.89%,53.72%,0.426;67.64%,94.59%,77.14%,95.83%,61.40%,0.554 and 76.47%,97.30%,83.81%,98.11%,69.23%,0.675,respectively.Conclusions The combined determination of BALF Xpert MTB/RIF,BD-960 rapid culture and Roche culture has high diagnostic value for BGT,which can improve diagnostic accuracy rate of BGT.
作者
吴琦
邹彦
张艳霞
陈礼刚
WU Qi;ZOU Yan;ZHANG Yanxia;CHEN Ligang(Department of Respiratory and Critical Care Medicine,Jingzhou First People's Hospital,Jingzhou 434020,Hubei,China)
出处
《检验医学》
2025年第8期793-797,共5页
Laboratory Medicine
