3种快速检测方法诊断盆腔结核价值分析

Diagnostic value of three methods in pelvic tuberculosis

目的探讨夹层杯法、Xpert MTB/RIF系统和改良抗酸染色法在结核性盆腔积液中的诊断价值。方法回顾性分析51例盆腔结核及38例盆腔恶性肿瘤病人的盆腔积液的夹层杯法、Xpert MTB/RIF系统和改良抗酸染色法的检测结果,比较3种快速方法的检测灵敏度及特异度。结果夹层杯法敏感性3.92%(2/51),特异性97.37%;Xpert MTB/RIF系统敏感性25.49%(13/51),特异性100.00%;改良抗酸染色法敏感性35.29%(18/51),特异性100.00%。改良抗酸染色法与夹层杯法及Xpert MTB/RIF系统比较,其阳性率较高,与夹层杯法差异有统计学意义(χ~2=14.06,P<0.01),但与Xpert MTB/RIF系统比较,差异无统计学意义(χ~2=3.20,P>0.05)。Xpert MTB/RIF系统和改良抗酸染色法联合诊断的阳性率为41.18%(21/51)。结论 Xpert MTB/RIF系统和改良抗酸染色法敏感性高、特异性好,两种方法联合应用效果更好,均适宜对盆腔结核进行辅助诊断。

Objective To investigate the value of sandwich cup collecting bacteria and smear method（ sandwich cup method）, Xpert MTB/RIF assay and modified Ziehl - Neelsen stain in the diagnosis of pelvic tuberculosis. Methods The results of Xpert MTB/RIF system and modified acid - fast staining were analyzed retrospectively. The sensitivity and specificity of the three rapid methods were compared. The results showed that the sensitivity and specificity of the three rapid methods were compared with those of pelvic fluid in 51 cases of pelvic tuberculosis and 38 cases of pelvic malignant tumor. Results The sensitivity of MTB in pelvic effusions of sandwich cup method was 3.92% （2/51）, the specificity was 97. 37% ; the sensitivity of the Xpert MTB/RIF system was 25.49% （ 13/51 ）, the specificity was 100. 00% ; the sensitivity of the modified acid - resistant staining method was 35. 29% （ 18/51 ）, the specificity was 97.37% , specificity of 100. 00%. Compared with the sandwich cup method and Xpert MTB/RIF system, the positive rate of the modified anti -acid staining method was significantly higher, and there was statistical significance between modified method and sandwich cup method（χ2 = 14.06, P 〈 0. 01 ）, but compared with the Xpert MTB/ significant（χ2 = 3.20, P 〉0.05）. The positive rate of Xpert MTB/RIF system RIF system, the difference was not statistically significant（X2 = 3.20, P 〉0.05）. The positive rate of Xpert MTB/RIF system and modified acid - fast staining was 41.18% （21/51）. Conclusion The positive rates of modified Ziehl - Neelsen stain and Xpert MTB/RIF assay were higher. Moreover, the combine of modified method and Xpert MTB/RIF assay can improve the diagnostic positive rate of pelvic tuberculosis, which is a valuable method in diagnosis of pelvic tuberculosis.