两种方法在检测肺泡灌洗液中结核分枝杆菌的结果分析

Analysis of the Results of Two Methods for Detecting Mycobacterium Tuberculosis in Alveolar Lavage Fluid

目的比较罗氏固体培养法和Gene Xpert MTB/RIF检测法对肺泡灌洗液的检出阳性率。方法对420例可疑肺结核患者的肺泡灌洗液进行罗氏培养与Gene Xpert MTB/RIF检测,比较2种检测方法的阳性率。结果罗氏培养法的阳性率为11.9%,Gene Xpert MTB/RIF检测法的阳性率为19.8%,与罗氏培养法比较,Gene Xpert MTB/RIF法的阳性率较高,差异具有统计学意义(P<0.001);以罗氏培养法为标准,Gene Xpert MTB/RIF检测法的敏感度为50.6%,特异度为97.6%,阳性预测值为84.0%,阴性预测值为88.9%。结论通过肺泡灌洗液检测Gene Xpert MTB/RIF检测系统与传统培养法在临床疑似肺结核病患者诊断中都具有重要意义,建议临床广泛推广应用。

Objective To compare the positive rate of alveolar lavage fluid by Roche solid culture and Gene Xpert MTB/RIF detection. Methods 420 patients with suspected pulmonary tuberculosis were examined by Roche culture and Gene Xpert MTB/RIF, and the positive rates of 2 methods were compared. Results The positive rate of Roche culture was 11.9%, and the positive rate of Gene Xpert MTB/RIF assay was 19.8%, compared with Roche culture, the positive rate of Gene Xpert MTB/RIF method was higher, and the difference was statistically significant（P 0.001）; Taking the Roche culture as the standard, the sensitivity of Gene Xpert MTB/RIF detection was 50.6%, the specificity was 97.6%, the positive predictive value was 84.0%, and the negative predictive value was 88.9%. Conclusion The detection of Gene Xpert MTB/RIF by alveolar lavage fluid and the traditional culture method are of great significance in the diagnosis of suspected pulmonary tuberculosis patients, it is suggested that the clinical application is widely used.