月经血结核杆菌FQ-PCR检测联合IGRA对女性生殖器结核诊断价值

Diagnostic Value of FQ-PCR Combined with IGRA for FGT in Menstrual Blood Mycobacterium Tuberculosis

目的:探讨月经血结核杆菌荧光定量PCR检测(FQ-PCR)联合γ-干扰素释放试验(IGRA)对女性生殖器结核(FGT)诊断价值。方法:选择2016年7月至2019年9月在我院就诊的156例输卵管性及不明原因不孕、复发性流产患者进行病因学检查、月经血结核杆菌FQ-PCR检测及IGRA检测。以内镜镜下表现及病理结果作金标准分为2组。分析月经血结核分枝杆菌FQ-PCR检测联合IGRA单独检测与联合检测对盆腔结核及内膜结核的漏诊率。结果:联合检测对盆腔结核漏诊率为14.29%,低于月经血结核分枝杆菌FQ-PCR检测单独检测的42.86%与IGRA的52.38%(P<0.05)。联合检测对盆腔结核漏诊率为11.76%,低于月经血结核分枝杆菌FQ-PCR检测单独检测的35.29%与IGRA的52.94%(P<0.05)。结论:月经血结核杆菌FQ-PCR检测及IGRA作为输卵管性及不明原因不孕、复发性流产患者FGT早期筛查手段均存在一定的漏检率,两种诊断方式联合检测可有效降低漏检率。

Objective:To explore the diagnostic value of fluorescent quantitative PCR(FQ-PCR)detection of mycobacterium tuberculosis in menstrual blood combined with interferon gamma release assay(IGRA)for female genital tuberculosis(FGT).Methods:A total of 156 cases of tubal infertility and recurrent abortion admitted to our hospital from July 2016 to September 2019 were selected for etiological examination,fluorescence quantitative PCR detection of Mycobacterium tuberculosis in menstrual blood and detection of interferon gamma release test.The patients were divided into 2 groups with the gold standard of endoscopic findings and pathological results.The rate of missed diagnosis was analyzed in both solo and combined detection.Results:The rate of missed diagnosis in combined detection was 14.29%,which was lower than 42.86%of PCR detection alone and 52.38%of interferon-γrelease test(P<0.05).The rate of missed diagnosis in combined detection was 11.76%,which was lower than 35.29%of PCR detection alone and 52.94%ofγ-interferon release test(P<0.05).Conclusion:As the early screening methods of FGT in tubal infertility and recurrent abortion,the detection of mycobacterium tuberculosis in menstrual blood by fluorescence quantitative PCR and interferon gamma release test have a certain rate of missed detection.The combined detection of the two diagnostic methods can effectively reduce the rate.