GeneXpert MTB/RIF技术与血清结核分枝杆菌特异性蛋白抗体联合检测在菌阴肺结核诊断中的价值

目的 探讨GeneXpertmTB/RIF技术和血清结核分枝杆菌特异性蛋白(tuberculosis specific antigen,TB-SA)抗体联合检测在菌阴肺结核诊断中的价值.方法 搜集2014年6月至2016年2月期间山东省滨州市结核病防治院临床确诊的住院菌阴肺结核患者119例和菌阳肺结核患者47例作为试验组,同期确诊的住院非结核病患者71例和健康者55人作为对照组.每组均留取晨痰和血液一份,晨痰进行GeneXpertmTB/RIF检测结核分枝杆菌,血液进行血清TB-SA抗体检测.结果 119例菌阴肺结核患者,GeneXpertmTB/RIF、血清TB-SA抗体检测和2种方法联合检测的敏感度分别为37.8%、68.1%和81.2%,特异度分别为100%、74.6%和74.6%.2种方法联合检测结果与GeneXpertmTB/RIF和血清TB-SA抗体检测结果比较,差异均有统计学意义(χ2=47.21、5.71,均P<0.01),GeneXpertmTB/RIF和血清TB-SA抗体检测结果比较,差异有统计学意义(χ2=21.86,P<0.01).结论 GeneXpertmTB/RIF和血清TB-SA抗体联合检测敏感度提高,对菌阴肺结核的诊断有较大价值.

Value of GeneXpert MTB/RIF and TB-SA antibody in diagnosis of pulmonary tuberculosis with negative smear culture

Objective To investigate the value of GeneXpert MTB/RIF and TB-SA antibody in diagnosis of bacteriological negative pulmonary tuberculosis.Methods The morning sputum and blood serum from 119 bacteriological negative pulmonary tuberculosis in patients and 71 non-tuberculosis cases and 55 healthy personn in Binzhou Tuberculosis Prevention and Treatment Hospital between June 2014 and February 2016 were collected and detected by Genexpert MTB/RIF and TB-SA antibody technology. Results The morning sputum and blood serum of the 119 bacteriological negative pulmonary tuberculosis in patients used GeneXpert MTB/RIF and TB-SA antibody technology with detection.Sensitivity of GeneXpert MTB/RIF and TB-SA antibody and 2 alliance technology were 37.8%,68.1% and 81.2%. Specificity of GeneXpert MTB/RIF and TB-SA antibody and 2 alliance technology were 100%,74.6% and 74.6%.The positive rate of comparing 2 alliance technology was siginificantly higher than those of GeneXpert MTB/RIF and TB-SA antibody method (χ2=47.21,5.71,both P <0.01);There was significant difference between GeneXpert MTB/RIF and TB-SA antibody method(χ2=21.86,P <0.01).Conclusions Sensitivity of 2 alliance technology are high,which is of great value for early diagnosis of bacteriological negative pulmonary tuberculosis.