五种方法联合检测对菌阴性肺结核的诊断价值分析

Diagnostic value of five combined methods in bacterial negative pulmonary tuberculosis

目的探讨实时定量聚合酶链反应(PCR)、结核分支杆菌抗体(TB-Ab)、结核菌素(PPD)、结核感染特异性T细胞检测(T-SPOT.TB)及结核分枝杆菌菌种鉴定基因及联合检测对菌阴性肺结核的诊断价值。方法选取2021年1—12月本院收治的80例初治痰菌阴性肺结核患者作为观察组,同期选取排除肺结核感染的80例肺部疾病患者作为对照组。两组均接受PCR、TB-Ab、PPD、T-SPOT.TB及结核分枝杆菌菌种鉴定基因检测。比较两组五种检测方法阳性率,比较五种检测方法及联合检测的准确度、灵敏度与特异度。结果观察组PCR、TB-Ab、PPD、T-SPOT.TB及结核分枝杆菌菌种鉴定基因检测阳性率均高于对照组,差异有统计学意义(P<0.05)。以痰培养检查为金标准,联合检测诊断的准确度高于PCR、TB-Ab、PPD,联合检测诊断的特异度高于PCR、TB-Ab、PPD、T-SPOT.TB及结核分枝杆菌菌种鉴定基因,差异有统计学意义(P<0.05);但5种检测方法及联合检测诊断的灵敏度比较差异无统计学意义。结论与PCR、TB-Ab、PPD、T-SPOT.TB及结核分枝杆菌菌种鉴定基因检测相比,联合检测诊断菌阴性肺结核的效果显著。

Objective To explore the diagnostic value of real-time quantitative polymerase chain reaction(PCR),mycobacterium tuberculosis antibody(TB-Ab),tuberculin(PPD),tuberculosis infected T cell detection(T-SPOT.TB)and Mycobacterium tuberculosis strain identification gene combined detection in bacterial negative pulmonary tuberculosis.Methods 80 patients with initially treated sputum negative pulmonary tuberculosis admitted to our hospital from January to December 2021 were selected as the observation group,and 80 patients with pulmonary disease excluded from pulmonary tuberculosis infection were selected as the control group during the same period.Both groups received PCR,TB-AB,PPD,T-SPOT.TB and Mycobacterium tuberculosis species identification gene tests.The positive rates of five detection methods were compared between the two groups,the accuracy,sensitivity and specificity of five detection methods and joint detection were compared.Results The positive rates of PCR,TB-AB,PPD,T-SPOT.TB and Mycobacterium tuberculosis species identification gene tests in observation group were higher than those in control group,and the difference was statistically significant(P<0.05).With sputum culture as the gold standard,the accuracy of combined detection was higher than that of PCR,TB-AB and PPD,and the specificity of combined detection was higher than that of PCR,TB-AB,PPD,T-SPOT.TB and Mycobacterium tuberculosis species identification gene tests,the difference was statistically significant(P<0.05);however,there was no significant difference in sensitivity between the 5 detection methods and the combined detection.Conclusion Compared with PCR,TB-AB,PPD,T-SPOT.TB and Mycobacterium tuberculosis species identification gene tests,the combined test has the significant effect on the diagnosis of bacteria negative pulmonary.