BALF结核杆菌检测联合T-SPOT.TB检测在菌阴肺结核诊断中的效能

Efficacy of Mycobacterium tuberculosis detection in BALF combined with T-SPOT.TB test in diagnosis of bacteriological negative pulmonary tuberculosis

目的:观察支气管肺泡灌洗液(BALF)结核杆菌检测联合结核感染T细胞斑点(T-SPOT.TB检测)在菌阴肺结核诊断中的效能。方法:选取2019年2月至2021年5月该院收治的82例疑似肺结核患者进行前瞻性研究。所有患者均接受BALF结核杆菌检测、T-SPOT.TB检测,以肺泡灌洗液罗氏培养和临床诊断结果为金标准,统计肺泡灌洗液罗氏培养和临床诊断结果、BALF结核杆菌检测和T-SPOT.TB检测单项及联合检测结果,比较BALF结核杆菌检测和T-SPOT.TB检测单项及联合检测诊断菌阴肺结核的效能。结果:82例疑似肺结核患者肺泡灌洗液罗氏培养和临床诊断结果诊断为肺结核病59例,检出率为71.95%;非肺结核病23例,检出率为28.05%。BALF结核杆菌检测联合T-SPOT.TB检测诊断菌阴肺结核的灵敏度、特异度、准确度、阳性预测值和阴性预测值均高于两者单项检测,差异有统计学意义(P<0.05);BALF结核杆菌检测与T-SPOT.TB检测的灵敏度、特异度、准确度、阳性预测值和阴性预测值比较,差异均无统计学意义(P>0.05)。结论:BALF结核杆菌检测联合T-SPOT.TB检测诊断菌阴肺结核的效能高于两者单项检测。

Objective:To observe efficacy of Mycobacterium tuberculosis detection in BALF combined with T-SPOT.TB test in diagnosis of bacteriological negative pulmonary tuberculosis.Methods:A prospective study was conducted on 82 patients with suspected pulmonary tuberculosis admitted to the hospital from February 2019 to May 2021.All patients received Mycobacterium tuberculosis detection in BALF and T-SPOT.TB test.Using the bronchoalveolar lavage fluid Roche culture and the clinical diagnosis results as the gold standard,the results of single Mycobacterium tuberculosis detection in BALF,single T-SPOT.TB test and combined detection were statistically analyzed.Then,the efficacies of single Mycobacterium tuberculosis detection in BALF,single T-SPOT.TB test and combined detection in the diagnosis of bacteriological negative pulmonary tuberculosis were compared.Results:Among 82 patients with suspected pulmonary tuberculosis,59 cases were diagnosed as pulmonary tuberculosis by Roche culture and clinical diagnosis with a detection rate of 71.95%and 23 cases were not diagnosed as pulmonary tuberculosis with the detection rate of 28.05%.The sensitivity,specificity,accuracy,positive predictive value and negative predictive value of Mycobacterium tuberculosis detection in BALF combined with T-SPOT.TB test in the diagnosis of bacteriological negative pulmonary tuberculosis were higher than those of the two single tests,and the differences were statistically significant(P<0.05).Conclusions:The efficacy of Mycobacterium tuberculosis detection in BALF combined with T-SPOT.TB test in the diagnosis of bacteriological negative pulmonary tuberculosis is higher than those of the two single tests.