支气管肺泡灌洗液RNA恒温扩增检测涂阴肺结核的诊断价值

目的评价支气管肺泡灌洗液结核分枝杆菌RNA恒温扩增检测(simultaneous amplification and testing for Mycobacterium tuberculosis,SAT-TB)对涂阴肺结核的诊断价值。方法选取涂阴肺结核组(观察组)95例和非结核病组(对照组)67例共计162例,两组患者均行纤维支气管镜检查,留取支气管肺泡灌洗液行荧光定量PCR(FQ-PCR),RNA恒温扩增检测(SAT-TB),结核菌快速培养,计算BALF的SAT-TB对涂阴肺结核诊断的敏感度,特异度,阳性预测值,阴性预测值。结果 SAT-TB检测BALF对诊断涂阴肺结核的敏感度为53.7%,特异度为98.5%,阳性预测值为98.1%,阴性预测值为60.0%,BALF的SAT-TB检测在敏感度,特异度,阳性预测值,阴性预测值与FQ-PCR法相比较均无显著性差异(χ~2值分别为3.572,0.341,0.679,1.603,P值均0.05)。结论 BALF中SAT-TB检测在涂阴肺结核中的敏感度,特异度均较高,且检测快速,对涂阴肺结核的快速诊断具有较大的应用价值。

Clinical value of simultaneous amplification and testing in bronchoalveolar lavage fluid in the diagnosis of smear-negative pulmonary tuberculosis