王蕊 1李妍 2杨健 2王盼婷 2张萌 2陈艳炯3
作者信息
- 1. 西安交通大学医学部病原生物学与免疫学系,陕西西安 710061||陕西省结核病防治研究所结核病参比实验室,陕西西安 710048
- 2. 陕西省结核病防治研究所结核病参比实验室,陕西西安 710048
- 3. 西安交通大学医学部病原生物学与免疫学系,陕西西安 710061
- 折叠
摘要
Abstract
Objective To evaluate the value of interferon- γ release assay(IGRA),acid fast staining(AFB)and real-time fluorescence quantitative nucleic acid amplification detection technology(Xpert MTB/RIF)for the diagnosis of tuberculosis.Methods A total of 397 patients with suspected tuberculosis who attended to the Shaanxi Provincial Institute for Tuberculosis Control and Prevention from June 2019 to June 2023 were se-lected as the study subjects,all the study subjects underwent IGRA,AFB and Xpert MTB/RIF tests simulta-neously,and the test results and case data of the patients were collected.Excluding 39 patients in whom tuber-culosis could not be diagnosed,finally 358 confirmed cases were included and divided into 141 cases with tu-berculosis and 217 cases without tuberculosis according to the clinical diagnosis.The positive detection and di-agnostic efficacy for tuberculosis of IGRA,AFB and Xpert MTB/RIF were compared.Results The sensitivity of IGRA,AFB and Xpert MTB/RIF assays was 95.74%,31.21%and 56.74%,respectively,while the sensi-tivity of IGRA was higher than that of AFB and Xpert MTB/RIF(χ2 =126.66,P<0.01;χ2=59.22,P<0.01),and the sensitivity of Xpert MTB/RIF was higher than that of AFB(χ2=18.65,P<0.01).The speci-ficity of IGRA,AFB and Xpert MTB/RIF assays was 60.37%,99.54%and 100.00%,respectively,and the specificity of AFB and Xpert MTB/RIF was higher than that of IGRA(χ2 =103.86,P<0.01;χ2=107.25,P<0.01),but the difference of specifity of between AFB and Xpert MTB/RIF had no statistical significance(χ2=1.00,P=0.32).The accuracy of IGRA,AFB and Xpert MTB/RIF assays was 74.30%,72.63%and 82.96%,respectively,and Xpert MTB/RIF had the highest accuracy,the difference of accuracy among the three methods was statistically significant(χ2 =12.30,P<0.01).The total consistent rate between IGRA and AFP test results was 31.21%(44/141),with positive consistent rate of 95.45%(42/44)and negative consistent rate of 4.12%(4/97);the total consistent rate between Xpert MTB/RIF and AFP test results was 74.47(105/141),with positive consistent rate of 100.00%(44/44)and consistent compliance rate of 62.89%(61/91).Conclusion In the diagnosis of tuberculosis,the specificity of Xpert MTB/RIF and AFB is higher than that of IGRA,while the sensitivity of IGRA and Xpert MTB/RIF is higher than that of AFB.The clinic can apply the three methods to the diagnosis of tuberculosis according to their respective advantages,so as to improve the efficiency of clinical diagnosis and treatment of tuberculosis.关键词
结核病/γ-干扰素释放试验/实时荧光定量核酸扩增检测技术/涂片抗酸染色镜检/阳性检出率Key words
tuberculosis/interferon-γrelease assay/Xpert MTB/RIF/acid fast staining/positive detection分类
医药卫生
