荧光定量PCR在肺结核诊断的优势对比研究

Comparative Study of the Advantages of Fluorescence Quantitative PCR in Diagnosing Pulmonary Tuberculosis

目的:分析在肺结核临床诊断中对肺泡灌洗液进行荧光定量聚合酶链式反应(polymerase chain reaction,PCR)、纤支镜灌洗液结核分枝杆菌培养及灌洗液刷片抗酸(刷片法)检测的诊断价值。方法:选取2022年1月—2023年12月清镇市中医医院收治的160例患者作为研究对象,根据是否患有肺结核分为肺结核组和非肺结核组,每组各80例,共送检160份肺泡灌洗液标本。分别采PCR、培养法及刷片法对肺泡灌洗液标准进行诊断分析,对比3类检测方式下的诊断效能。以纤支镜肺泡灌洗液结核分枝杆菌培养检测结果为金标准,分析计算PCR及刷片法检测诊断的Kappa值,同时对比3种检测方式下的阳性预测值(PPV)和阴性预测值(NPV)。结果:肺结核组的PCR诊断阳性率高于培养法,差异无统计学意义(χ^(2)=10.03,P>0.05);PCR诊断阳性率高于刷片法,差异有统计学意义(χ^(2)=16.667,P<0.05);培养法诊断阳性率高于刷片法,差异有统计学意义(χ^(2)=10.03,P<0.05)。3种检测方法中PCR检测灵敏度、特异性最高,培养法次之,刷片法最低。PCR检测一致性较好(Kappa=0.82),刷片法检测结果一致性一般(Kappa=0.63)。3种诊断方式阳性预测值比较,差异无统计学意义(P>0.05);PCR阴性预测值高于刷片法,差异有统计学意义(P<0.05)。结论:荧光定量PCR在诊断肺结核方面具有较高的诊断效能,诊断优势明显,可作为一种有价值的工具用于肺结核的诊断。

Objective:To analyze the diagnostic value of polymerase chain reaction(PCR),mycobacterium tuberculosis culture in bronchoscope lavage fluid and brush antacid detection(brush method)in the clinical diagnosis of pulmonary tuberculosis.Method:160 patients admitted to Qingzhen Hospital of Traditional Chinese Medicine from January 2022 to December 2023 were selected as research objects and divided into pulmonary tuberculosis group and non-pulmonary tuberculosis group according to whether they had tuberculosis,with 80 cases in each group.A total of 160 samples of alveolar lavage fluid were sent for examination.PCR,culture method and brush method were used to diagnose and analyze the standard of alveolar lavage fluid,and the diagnostic efficiency of the three kinds of detection methods was compared.With the results of Mycobacterium tuberculosis culture in bronchoscopic alveolar lavage fluid as the gold standard,the Kappa values detected by PCR and brush method were analyzed and calculated,and the positive predictive value(PPV)and negative predictive value(NPV)under the three detection methods were compared.Result:The postive rate of PCR diagnosis in pulmonary tuberculosis group was higher than that of culture method and the difference was not statistically significant(χ^(2)=16.667,P<0.05).The postive rate of culture method was higher than that of brush method,and the difference was statistically significant(χ^(2)=10.03,P<0.05)Among the three methods,PCR had the highest sensitivity and specificity,followed by culture method and brush method had the lowest.The consistency of PCR detection was good(Kappa=0.82),and the consistency of brush detection was general(Kappa=0.63).There was no significant difference in positive predictive value among the three diagnostic methods(P>0.05).The negative predictive value of PCR was higher than that of brush method,and the difference was statistically significant(P<0.05).Conclusion:Fluorescent quantitative PCR has a high diagnostic efficiency in the diagnosis of pulmonary tuberculosis,the diagnostic advantages are obvious,and can be used as a method.