不同检测方法对肺结核患者肺泡灌洗液中结核杆菌的诊断价值

发布时间：2018-11-13 11:23

【摘要】：目的:探讨不同检测方法对肺结核患者肺泡灌洗液(bronchoalveolar lavage fluid,BALF)中结核杆菌的诊断价值。方法:收集2013年1月至2015年12月在长沙市中心医院住院的100例患者的BALF,其中临床确诊为肺结核患者65例,另选取35例作为对照,分别应用BALF涂片法、聚合酶链反应(PCR)、膜-反向斑点杂交技术(reverse dot blot,RDB)同步检测肺结核杆菌。结果:BALF涂片法,PCR检测,RDB法对结核杆菌诊断阳性率依次为43.08%,73.84%,92.31%,3种检测方法阳性率比较差异有统计学意义(P0.05)。BALF涂片法灵敏度、特异度、符合率、阴性预测值分别为43.08%,88.57%,59.00%,45.59%;PCR检测分别为73.85%,100.00%,83.00%,67.31%;RDB法分别为92.31%,100.0%,95.00%,87.50%。结论:RDB法不仅能准确诊断结核杆菌,且能快速、简单地分辨肺结核杆菌耐链霉素(SM)、利福平(RFP)、异烟肼(INH)基因型,具有较高的临床应用价值。
[Abstract]:Objective: to investigate the diagnostic value of different detection methods in pulmonary tuberculosis patients with alveolar lavage fluid (bronchoalveolar lavage fluid,BALF). Methods: from January 2013 to December 2015, 100 patients with BALF, in Changsha Central Hospital were collected, 65 of whom were clinically diagnosed as pulmonary tuberculosis and 35 as control. BALF smear method and polymerase chain reaction (PCR),) were used respectively. Membrane reverse dot blot hybridization (reverse dot blot,RDB) was used to detect pulmonary tuberculosis bacilli simultaneously. Results: the positive rates of BALF smear, PCR and RDB in the diagnosis of Mycobacterium tuberculosis were 43.08 and 73.84 and 92.31% respectively. There were significant differences among the three methods (P0.05) in the sensitivity of). BALF smear method. The specificity, coincidence rate and negative predictive value were 43.08 and 88.570.59.00, respectively. The PCR values were 73.85 and 100.00and 83.00 and 67.31, respectively. The RDBs were 92.31 and 100.0 and 87.50, respectively. Conclusion: RDB method can not only accurately diagnose Mycobacterium tuberculosis, but also can easily distinguish streptomycin resistant (SM), rifampicin (RFP), isoniazid (INH) genotypes.
【作者单位】：长沙市中心医院病理科;长沙市中心医院呼吸内科;
【基金】：湖南省卫生和计划生育委员会科研课题(B2015-146)~~
【分类号】：R521

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