支气管镜联合T-SPOT对肺结核的诊断效能评价

发布时间：2018-02-02 18:36

本文关键词： 肺结核支气管镜 T-SPOT 诊断效能　出处：《实用医学杂志》2017年10期 　论文类型：期刊论文

【摘要】：目的:探讨支气管镜联合T-SPOT对肺结核的诊断效能。方法:纳入2015年2月至2016年4月我科住院的高度疑似肺结核病例248例,据痰标本来源途径不同分为对照组、雾化组、支气管镜组,据检查方式的不同分为支气管镜组、T-SPOT组、支气管镜+T-SPOT组,行各组痰抗酸涂片阳性率、肺结核诊断率及诊断效能的比较及支气管镜安全性的评估。结果:支气管镜组痰抗酸涂片阳性率最高(37.173%),3组间有统计学差异(P=0.001);支气管镜+T-SPOT组肺结核诊断率最高(92.670%),3组间有统计学差异(P=0.000);支气管镜+T-SPOT组诊断肺结核的特异度、灵敏度、阳性预测值、阴性预测值、阳性似然比及约登指数最高,阴性似然比最低;支气管镜组并发症有3例出血,1例气胸,1例心律失常。结论:支气管镜联合T-SPOT可提升肺结核的诊断效能,安全可靠。
[Abstract]:Objective: to investigate the diagnostic efficacy of bronchoscopy combined with T-spot in the diagnosis of pulmonary tuberculosis. Methods: from February 2015 to April 2016, 248 highly suspected pulmonary tuberculosis cases were included in our department. According to the origin of sputum samples were divided into control group atomization group bronchoscopy group according to different examination methods divided into bronchoscopy group T-spot group bronchoscopy T-spot group. The positive rate of sputum acid-resistant smear, the diagnosis rate and diagnostic efficacy of pulmonary tuberculosis and the safety evaluation of bronchoscopy were compared. Results: the highest positive rate of sputum acid-resistant smear was 37.173% in bronchoscopy group. There was statistical difference among the three groups. The diagnosis rate of pulmonary tuberculosis in T-spot group was the highest (92.670%). The specificity, sensitivity, positive predictive value, negative predictive value, positive likelihood ratio and Jordan index were the highest and the negative likelihood ratio was the lowest in the T-spot group. The complications of bronchoscope group included 3 cases of hemorrhage and 1 case of pneumothorax arrhythmia. Conclusion: bronchoscopy combined with T-spot can improve the diagnostic efficiency of pulmonary tuberculosis and is safe and reliable.
【作者单位】：第四军医大学唐都医院呼吸与危重症医学科;
【基金】：国家公益性行业科研专项(编号:201402024)
【分类号】：R521
【正文快照】： 【英文13期未换】我国是全世界肺结核高发病率国家[1],由于人类免疫缺陷、耐药菌株、贫困人口流动的增加等影响其发病率仍在增加,但很多肺结核患者因无咳痰、痰液质量或检测能力等因素,存在大量痰抗酸杆菌涂片阴性的患者。有报道临床上结核分枝杆菌检测阳性率仅15%~20%,肺外及

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