[1]王少华,杨 翰,李爱芳,等.三种实验方法检测胸腔积液对结核性胸膜炎的诊断价值分析[J].现代检验医学杂志,2019,34(03):104-108.[doi:10.3969/j.issn.1671-7414.2019.03.025]
　WANG Shao-hua,YANG Han,LI Ai-fang,et al.Diagnostic Value of Three Detection Methodsof Hydrothorax for Tuberculous Pleurisy[J].Journal of Modern Laboratory Medicine,2019,34(03):104-108.[doi:10.3969/j.issn.1671-7414.2019.03.025]
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三种实验方法检测胸腔积液对结核性胸膜炎的诊断价值分析()
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《现代检验医学杂志》[ISSN:/CN:]

卷:
第34卷
期数:
2019年03期
页码:
104-108
栏目:
论著
出版日期:
2019-06-20

文章信息/Info

Title:
Diagnostic Value of Three Detection Methodsof Hydrothorax for Tuberculous Pleurisy
文章编号:
1671-7414(2019)03-104-05
作者:
王少华; 杨 翰; 李爱芳; 崔晓利
(西安市胸科医院检验科,西安 710061)
Author(s):
WANG Shao-hua; YANG Han; LI Ai-fang; CUI Xiao-li
(Department of Clinical Laboratory,Xi'an Chest Hospital,Xi'an710061,China)
关键词:
结核性胸膜炎;  GeneXpert MTB/RIF;  结核感染T细胞斑点试验;  结核分枝杆菌
分类号:
R521.7; R466.19
DOI:
10.3969/j.issn.1671-7414.2019.03.025
文献标志码:
A
摘要:
目的 探讨GeneXpert MTB/RIF实验、结核感染T细胞斑点试验(T-SPOT.TB)以及结核分枝杆菌液体培养在结核性胸膜炎诊断中的价值。方法 选取临床已经确诊结核性胸膜炎的患者142例和非结核性胸膜炎患者51例,对其胸腔积液样本分别进行GeneXpert MTB/RIF检测、T-SPOT.TB以及结核分枝杆菌培养,分析比较三种方法并联和串联对结核性胸膜炎的诊断价值。结果 结核性胸膜炎患者T-SPOT.TB的阳性率显著高于其他两种方法。GeneXpert MTB/RIF检测、T-SPOT.TB以及结核分枝杆菌培养的敏感度分别为16.9%,81.0%和24.6%,特异度分别为98.0%,33.3%和86.3%,其中T-SPOT.TB试验的敏感度最高,特异度最小。三种方法串联后形成的四种不同方案的敏感度均低于19%,特异度均高于90%。三种方法并联后形成的四种不同方案的敏感度存在差异,其中GeneXpert MTB/RIF检测与结核培养试验并联方案的敏感度为29.6%,显著低于其他三种方案,其特异度为86.3%,显著高于其他三种方案。结论 在结核性胸膜炎诊断中,T-SPOT.TB试验具有较高的敏感度,而GeneXpert MTB/RIF检测以及结核分枝杆菌培养具有较高的特异度; 三者不同串联方案均具有很高的特异度; 并联方案中,GeneXpert MTB/RIF检测与结核培养试验并联的诊断特异度最高,对通过胸腔积液诊断结核性胸膜炎提供重要参考价值。
Abstract:
Objective To investigate the value of GeneXpertMTB/RIF test,T cell spot test(T-SPOT.TB)and liquid culture of Mycobacterium tuberculosis in the diagnosis of tuberculous pleurisy.Methods142 patients who were clinically diagnosed as tuberculous pleurisyand 51 patients who were clinically diagnosed as non-tuberculous pleurisy wereselected,the pleural fluid samples were tested by GeneXpert MTB/RIF,T-SPOT.TB and Mycobacterium tuberculosis,respectively.Analyzed and compared the diagnostic value of three methods in parallel and in series for tuberculous pleurisy.Results The positive rate of T-SPOT.TB in patientswith tuberculous pleurisy was significantly higher than the other two methods.The sensitivity of GeneXpert MTB/RIF test,T-SPOT.TB and Mycobacterium tuberculosis culture were 16.9%,81.0% and 24.6%,respectively,and the specificities were 98.0%,33.3% and 86.3%,respectively,of which T-SPOT.TB test thehighest sensitivity and the lowest specificity.The sensitivity of the four different schemes formed by the three methods in series was less than 19%,and thespecificity was higher than 90%.The sensitivity of the four different schemes formed by the parallel connection of the three methods was different.The sensitivity of the scheme of GeneXpert MTB/RIF in parallel with the tuberculosis culture test was 29.6%,which was significantly lower than the other three schemes.The degree was 86.3%,which was significantly higher than the other three programs.Conclusion In the diagnosis of tuberculous pleurisy,the T-SPOT.TB test has higher sensitivity,while the GeneXpert MTB/RIF test and Mycobacterium tuberculosis culture have higher specificity.The three different tandem schemes have high specificity.GeneXpert MTB/RIF detection and tuberculosis in a parallel scheme,which provides an important reference value for the diagnosis of tuberculous pleurisy by pleural effusion.

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相似文献/References:

[1]曾　路,王　曼,刘　侠,等.Xpert MTB/RIF在结核性胸膜炎诊断中的研究进展[J].现代检验医学杂志,2019,34(06):161.[doi:10.3969 ／ j.issn.1671-7414.2019.06.041]
　ZENG Lu,WANG Man,LIU Xia,et al.Research Progress of Xpert MTB/RIF in Diagnosis of Tuberculous Pleurisy[J].Journal of Modern Laboratory Medicine,2019,34(03):161.[doi:10.3969 ／ j.issn.1671-7414.2019.06.041]

备注/Memo

备注/Memo:
作者简介:王少华(1985-),女,本科,主管检验师,主要从事结核分枝杆菌实验室诊断及其耐药性检测等工作,E-mail:shaohua1985823@163.com。 通讯作者:崔晓利,副主任检验师,从事结核病实验室诊断及结核病分子诊断等研究,E-mail:291824412@qq.com。 收稿日期:2018-11-09 修回日期:2019-03-15
更新日期/Last Update: 2019-06-20