GeneXpert MTB/RIF检测胸膜活检组织对结核性胸膜炎的诊断价值

The diagnostic value of GeneXpert MTB/RIF in detectiuon of pleural biopsy tissue in tuberculous pleurisy

目的探究GeneXpert结核分枝杆菌/利福平耐药(MTB/RIF)检测胸膜活检组织对结核性胸膜炎的诊断价值。方法选取2019年1月至2021年3月赣州市第五人民医院收治的60例有胸腔积液疑似结核性胸膜炎患者作为研究对象,均行常规胸水检测和GeneXpert MTB/RIF检测胸膜活检组织。以痰培养结果作为金标准,比较两种检测方法的诊断效能。结果60例疑似结核性胸膜炎患者中,痰培养确诊结核性胸膜炎52例,非结核性胸腔积液8例。GeneXpert MTB/RIF检测胸膜活检组织诊断的灵敏度、准确度分别为96.15%、95.00%,均高于常规胸水检测的80.77%、76.67%,差异有统计学意义(P<0.05);GeneXpert MTB/RIF检测胸膜活检组织诊断的特异度为87.50%,高于常规胸水检测的50.00%,但差异无统计学意义。结论GeneXpert MTB/RIF检测胸膜活检组织对结核性胸膜炎诊断的灵敏度、特异度及准确度均较高,能为结核性胸膜炎的诊治提供重要参考信息。

Objective To explore the diagnostic value of GeneXpert Mycobacterium Tuberculosis/rifampicin(MTB/RIF)in detectiuon of pleural biopsy tissue in tuberculous pleurisy.Methods 60 patients with pleural effusion and suspected of tuberculous pleurisy admitted to the Fifth People's Hospital of Ganzhou from January 2019 to March 2021 were selected as the research subjects,all patients underwent conventional pleural effusion detection and GeneXpert MTB/RIF detection of pleural biopsy tissue.The results of sputum culture were used as the gold standard,the diagnostic performance were compared between the two methods.Results Among the 60 patients with suspected of tuberculous pleurisy,52 cases were diagnosed with tuberculous pleurisy by sputum culture,and 8 cases were diagnosed with non-tuberculous pleural effusion.The sensitivity,specificity and accuracy of GeneXpert MTB/RIF detection of pleural biopsy tissue were 96.15%,95.00%,respectively,which were higher than 80.77%,76.67%of conventional pleural effusion detection,and the differences were statistically significant(P<0.05);the specificity of GeneXpert MTB/RIF detection of pleural biopsy tissue was 87.50%,which was higher than 50.00%of conventional pleural effusion detection,but the difference was not statistically significant.Conclusion GeneXpert MTB/RIF has high sensitivity,specificity and accuracy in the diagnosis of tuberculous pleurisy,which can provide important reference information for the diagnosis and treatment of tuberculous pleurisy.