中国医学前沿杂志（电子版）2026，Vol.18Issue(3)：46-51,6.DOI:10.12037/YXQY.2026.03-07
超灵敏脂阿拉伯甘露聚糖抗原尿液检测对HIV阴性肺结核的诊断价值
Diagnostic value of ultrasensitive urine lipoarabinomannan antigen testing for pulmonary tuberculosis in HIV negative patients
摘要
Abstract
Objective To evaluate the diagnostic accuracy of an ultrasensitive electrochemiluminescence assay for detecting urinary lipoarabinomannan(LAM)in HIV-negative individuals with presumptive pulmonary tuberculosis.Methods HIV-negative patients(≥18 years)with suspected pulmonary tuberculosis admitted to Beijing Chest Hospital,Capital Medical University from January to May 2025.Sputum samples from all participants were subjected to smear microscopy,Xpert MTB/RIF assay,and mycobacterial culture.Concurrent urine samples were tested using the ultrasensitive LAM assay.Diagnostic performance was assessed against a composite reference standard for pulmonary tuberculosis diagnosis.Results Urine samples were collected from 280 HIV-negative adults with suspected pulmonary tuberculosis.Among them,144(51.4%)were microbiologically confirmed,64(22.9%)were clinically diagnosed,and 72(25.7%)were classified as non tuberculosis patients.Taking comprehensive diagnosis as the gold standard,the urinary LAM assay demonstrated a sensitivity of 51.44%(95%CI:44.65%-58.23%)and a specificity of 98.61%(95%CI:95.91%-100.00%).The sensitivity of combined urine LAM and sputum Xpert testing[76.08%(95%CI:70.29%-81.86%)]was higher than that of urine LAM testing alone.Conclusions The ultrasensitive urine LAM assay shows promising diagnostic accuracy and could offer a rapid tuberculosis diagnostic solution for HIV-negative patients with pulmonary tuberculosis.关键词
肺结核/尿液脂阿拉伯甘露聚糖/非痰液/诊断准确性Key words
Pulmonary tuberculosis/Urine lipoarabinomannan/Non-sputum-based/Diagnostic accuracy引用本文复制引用
张家畅,王艺霖,尚媛媛,石金,荆玮,逄宇,杨新婷..超灵敏脂阿拉伯甘露聚糖抗原尿液检测对HIV阴性肺结核的诊断价值[J].中国医学前沿杂志（电子版）,2026,18(3):46-51,6.基金项目
Beijing Municipal Health and Health Technology Achievement(BHTPP2024082) （BHTPP2024082）
Beijing Research Ward Excellence Program(BRWEP2024W042160102) （BRWEP2024W042160102）
Capital's Health Development Research Project(2024-1-1041) 北京市卫生健康科技成果和适宜技术推广项目(BHTPP2024082) （2024-1-1041）
研究型病房卓越临床研究计划(BRWEP2024W042160102) （BRWEP2024W042160102）
首都卫生发展科研专项项目(首发2024-1-1041) （首发2024-1-1041）
