摘要
目的探讨TSPOT.TB与XpertMTB/RIF检测在高海拔地区肺结核诊断中的应用价值。方法选取高海拔地区84例结核病患者,对其进行TSPOT.TB与XpertMTB/RIF检测,分析两种检测方法的阴性与阳性预测值、准确度、灵敏度、特异度、漏诊发生率。结果对肺结核患者分别进行TSPOT.TB和XpertMTB/RIF检测,阳性检出率分别为82.6%(38/46)、26.1%(12/46),对肺外结核患者阳性检出率分别为31.7%(12/38)、0%(0/38)。两种检测方法检出率比较差异有统计学意义(P<0.05);TSPOT.TB检出准确度、灵敏度和特异度分别为76.2%、82.6%、64.3%。XpertMTB/RIF检出准确度、灵敏度和特异度分别为64.3%、35.8%、100.0%,两种方法比较差异有统计学意义(P<0.05);XpertMTB/RIF漏诊发生率低于TSPOT.TB(P<0.05);对照组男性比例高于女性,66~70年龄段高海拔肺外结核发病率最高,合并高血压发生率高于合并糖尿病发生率。结论在高海拔地区肺结核诊断中,TSPOT.TB和XpertMTB/RIF检测均具有较高阳性预测值和特异度,临床价值高。与XpertMTB/RIF检测,TSPOT.TB检测具有更高检测率,可降低漏诊发生率,患者满意度高,可进一步提高患者治疗有效率。
Objective To explore the application value of TSPOT.TB and XpertMTB/RIF detection in the diagnosis of pulmonary tuberculosis at high altitude.Methods 84 cases of suspected tuberculosis in high altitude area were selected for TSPOT.TB and XpertMTB/RIF detection,and the predictive value,accuracy,sensitivity and specificity,and incidence of missed diagnosis in the two groups were analyzed.Results Tspot.tb and XpertMTB/RIF were detected in patients with pulmonary tuberculosis,respectively.The positive detection rates were 82.6%(38/46),26.1%(12/46),and 31.7%(12/38)and 0%(0/38),respectively.The detection rates of the two diagnoses were statistically significant(P<0.05).the accuracy,sensitivity and specificity of TSPOT.TB detection were 76.2%,82.6%and 64.3%,respectively.The detection accuracy,sensitivity and specificity of XpertMTB/RIF were 64.3%,35.8%and 100.0%,respectively,and the two diagnostic rates were statistically significant(P<0.05).The incidence of missed diagnosis in XpertMTB/RIF was lower than that in the TSPOT.TB(P<0.05).The proportion of males in the control group was higher than that in females.The incidence of high-altitude extra pulmonary tuberculosis was the highest in the 66-70 age group,and the incidence of hypertension was higher than the incidence of diabetes.Conclusion TSPOT.TB and XpertMTB/RIF have high positive predictive value and specificity in the diagnosis of pulmonary tuberculosis in high altitude areas,and have high clinical value.Compared with XpertMTB/RIF test and TSPOT.TB test,the detection rate is higher,which can reduce the incidence of missed diagnosis,improve patient satisfaction,and further improve the treatment efficiency of patients.
作者
祁云清
阿祥仁
李玉环
谷生文
常璠
QI Yunqing;A Xiangren;LI Yuhuan;GU Shengwen;CHANG Fan(Xining Chengxi District Center for Disease Control and Prevention,Xining,Qinghai 810000,China;Laboratory Department,Qinghai People′s Hospital,Xining,Qinghai 810007,China;Department of Clinical Laboratory,Third People′s Hospital of Xining,Xining,Qinhai 810005,China)
出处
《国际检验医学杂志》
CAS
2019年第23期2868-2871,2876,共5页
International Journal of Laboratory Medicine
基金
青海省医学检验临床医学研究中心项目（2018-SF-L3）
