RNA恒温扩增实时荧光检测在痰涂片阴性肺结核中的诊断价值

Diagnostic value of simultaneous amplification and testing assay in sputum smear-negative tuberculosis

目的探讨应用结核分枝杆菌RNA恒温扩增实时荧光检测(SAT-TB)以及SAT-TB联合结核T细胞斑点试验(T-SPOT.TB)对痰涂片阴性肺结核的诊断价值。方法对2016年12月至2017年12月在四川大学华西医院就诊的101例疑似肺结核患者进行结核分枝杆菌快速培养(MGIT960)、T-SPOT.TB以及SAT-TB检测,分析应用SAT-TB技术以及SAT-TB联合T-SPOT.TB对检测痰涂片阴性肺结核的诊断价值。结果101例疑似肺结核患者中84例临床确诊为肺结核,17例为非肺结核。SAT-TB和T-SPOT.TB检测的灵敏度分别为63.10%和68.42%,特异性分别为94.12%和63.64%,AUC值分别为0.79和0.66。SAT-TB和T-SPOT.TB联合检测的阳性预测值为100%。结论SAT-TB对于痰涂片阴性肺结核的诊断价值较高,联合T-SPOT.TB检测时能有效减少肺结核的漏诊。

Objective To explore the diagnostic values of simultaneous amplification and testing assay for the detection of Mycobacterium tuberculosis(SAT-TB)and SAT-TB combined with T-SPOT.TB for sputum smear-negative tuberculosis.Methods Rapid culture of Mycobacterium tuberculosis(MGIT960),T-SPOT.TB and SAT-TB tests were applied in 101 suspected patients with tuberculosis at the West China Hospital of Sichuan University from December 2016 to December 2017.Diagnostic values of SAT-TB technology and SAT-TB combined with T-SPOT.TB for tuberculosis with negative sputum smear were further analyzed.Results Of the 101 suspected patients,84 were confirmed with tuberculosis and 17 were diagnosed with non-tuberculosis.The SAT-TB and T-SPOT.TB tests had the sensitivities of 63.1%and 68.42%,specificities of 94.12%and 63.64%,and AUC values of 0.79 and 0.66,respectively.The positive predictive value of the combined SAT-TB and T-SPOT.TB test was 100%.Conclusions SAT-TB has a high diagnostic value for patients with sputum smear-negative pulmonary tuberculosis.The combined detection of SAT-TB and T-SPOT.TB can reduce missed diagnosis of tuberculosis.