支气管肺泡灌洗液的Xpert&MTB/RIF检测对肺结核的诊断价值分析

目的 探讨Xpert&MTB/RIF检测法在支气管肺泡灌洗液结核分枝杆菌检测中的应用价值.方法 选取2018年5月～2019年5月山东省枣庄市肿瘤医院收治的150例疑似肺结核患者为研究对象,以支气管肺泡灌洗液作为病原学检测标本,分别以病原学诊断活动性结核病和临床诊断活动性结核病为金标准,以Xpert&MTB/RIF为待...

Analysis of diagnostic value of Xpert MTB/RIF detection of bronchoalveolar lavage fluid for pulmonary tuberculosis

Objective To explore the application value of Xpert MTB/RIF detection method in the detection of Mycobacterium tuberculosis in bronchoalveolar lavage fluid.Methods 150 cases of suspected pulmonary tuberculosis patients admitted to Zaozhuang Cancer Hospital in Shandong Province from May 2018 to May 2019 were selected as the research objects.Bronchoalveolar lavage fluid was used as the pathogenic test specimens to diagnose active tuberculosis and clinical diagnosis respectively.Active tuberculosis is the gold standard,and Xpert MTB/RIF is used as the test standard to analyze the diagnostic value of Xpert MTB/RIF in the etiological and clinical diagnosis of tuberculosis.Results Among 150 lavage fluid specimens,130 cases of tuberculosis were diagnosed,45 cases were positive for acid-fast bacilli by centrifugal smear acid-fast staining,the positive rate was 34.62%;57 cases were positive for acid-fast bacilli by Xpert MTB/RIF detection,and the positive rate was 43.85%;The positive rate of Xpert MTB/RIF detection method of acid-fast bacilli was significantly higher than that of centrifugal smear acid-fast staining method,and the difference was statistically significant(P<0.05).Among the 130 cases of pulmonary tuberculosis,57 cases(43.95%)were diagnosed pathogenically,67 cases(51.54%)were diagnosed clinically;102 cases(78.46%)of pulmonary tuberculosis complicated with bronchial tuberculosis,and 107 cases(82.31%)of simple pulmonary tuberculosis.The sensitivity of Xpert MTB/RIF in the pathogenic diagnosis and clinical diagnosis of tuberculosis was 77%(95%CI:63%~88%)Sum 52%(95%CI:41%~63%)(P<0.05);the sensitivity of pulmonary tuberculosis combined with bronchial tuberculosis was 81%(95%CI:67%~89%),the sensitivity of simple tuberculosis is 46%(95%CI:35%~59%);the specificity of pathogenic diagnosis and clinical diagnosis of tuberculosis,combined bronchial tuberculosis and simple pulmonary tuberculosis are all 100%(95%CI:98%~100%).Xpert MTB/RIF detection is more sensitive to the pathogenic diagnosis of tuberculosis than the clinical diagnosis of tuberculosis,and the sensitivity of pulmonary tuberculosis combined with bronchial tuberculosis is higher than that of simple pulmonary tuberculosis(P<0.05);the detection load of MTB nucleic acid in bronchoalveolar lavage fluid is higher In the clinical diagnosis of tuberculosis(P<0.05).Conclusion Xpert MTB/RIF detection of bronchoalveolar lavage fluid has high value and sensitivity in the diagnosis of pulmonary tuberculosis,which helps to improve the detection rate of the cause of pulmonary tuberculosis.