全血γ干扰素释放试验联合支气管镜检查诊断菌阴肺结核及结核性胸膜炎的价值

Value of Whole Blood Interferon-γRelease Test Combined with Bronchoscopy in the Diagnosis of Bacterial Negative Pulmonary Tuberculosis and Tuberculous Pleurisy

目的:探究全血γ干扰素释放试验(IGRAs)联合支气管镜检查诊断菌阴肺结核及结核性胸膜炎的价值。方法:选取2019年1月—2021年1月广西壮族自治区南溪山医院初诊肺结核患者(包括结核胸膜炎患者)及其他肺部疾病患者100例作为研究对象,根据诊断结果分为肺结核组与非肺结核组,各50例。两组均进行痰液涂片及IGRAs联合支气管镜检查。比较两种方法的诊断差异,计算敏感度、特异度、阳性预测值、阴性预测值。结果:IGRAs联合支气管镜检查的敏感度、阳性预测值及阴性预测值均高于痰液涂片检查,特异度低于痰液涂片检查,差异有统计学意义(P<0.05)。结论:IGRAs联合支气管镜检查诊断菌阴肺结核及结核性胸膜炎的价值较高,可提高检测敏感度、阳性预测值及阴性预测值,为临床肺结核的诊断提供有力依据。

Objective:To investigate the value of whole blood interferon-gamma release assay(IGRAs)combined with bronchoscopy in the diagnosis of smear-negative pulmonary tuberculosis and tuberculous pleurisy.Methods:From January 2019 to January 2021,100 patients with newly diagnosed pulmonary tuberculosis(including patients with tuberculosis pleurisy)and other lung diseases in Nanxishan Hospital of Guangxi Zhuang Autonomous Region were selected as the research objects.According to the diagnosis results,they were divided into tuberculosis group and non-tuberculosis group,50 cases in each group.Both groups underwent sputum smear and IGRAs combined with bronchoscopy.The diagnostic differences of the two methods were compared,and the sensitivity,specificity,positive predictive value,and negative predictive value were calculated.Results:The sensitivity,positive predictive value and negative predictive value of IGRAs combined with bronchoscopy were higher than that of sputum smear,and the specificity was lower than that of sputum smear,the difference was statistically significant(P<0.05).Conclusion:IGRAs combined with bronchoscopy has a high value in the diagnosis of smear-negative pulmonary tuberculosis and tuberculous pleurisy,which can improve the detection sensitivity,positive predictive value and negative predictive value,and provide a strong basis for the diagnosis of clinical pulmonary tuberculosis.