三种实验室诊断技术在结核病诊断中的应用价值

目的评估三种常见的实验室诊断技术在肺结核诊断中的应用价值.方法选取2020年1~8月初诊为肺结核的患者584例为观察组,对患者留取的痰标本分别进行GeneXpert系统检测、分枝杆菌培养和涂片抗酸染色检查.以临床诊断为金标准,比较三种检查方法的差异.结果193例结核患者中GeneXpert系统阳性率为67.4%,特异性为98.5%;分枝杆菌培养阳性率为60.6%,特异性为99.5%;涂片抗酸染色阳性率25.9%,特异性为95.1%.GeneXpert阳性率>痰培养阳性率>痰涂片阳性率,并且GeneXpert系统检测利福平耐药性的敏感率为93.3%.结论三种实验室检测方法各有优劣,临床上应该根据实际情况将三种实验室检测方法联合运用,发挥最大的检测效能.GeneXpert系统检测耗时短、阳性率高,还能检测利福平的耐药性,值得推广和应用.

Objective To explore application value of three laboratory diagnostic techniques in the diagnosis of pulmonary tuberculosis.Methods 584 patients with pulmonary tuberculosis in Quzhou people's Hospital during 2020 were selected as the observation group.The sputum samples were detected by GeneXpert system,mycobacterium culture and acid-fast staining of smear.According to the final clinical diagnosis as the gold standard,compare the differences of the three inspection methods.Results In 193 TB patients,the positive rate of GeneXpert system was 67.4%,and the specificity was 98.5%;the positive rate of mycobacterium culture was 60.6%,and the specificity was 99.5%;the positive rate of acid-resistant staining was 25.9%,and the specificity was 95.1%.GeneXpert positive rate>sputum culture positive rate>sputum smear positive rate,and the sensitivity rate of GeneXpert system to detect rifampicin resistance was 93.3%.Conclusion Each of the three laboratory testing methods has its own advantages and disadvantages.In clinical practice,these three laboratory testing methods should be combined according to the actual situation to maximize the detection efficiency.