[1]周 祎,张 宁,刘晓荣,等.结核感染T淋巴细胞实验和Xpert MTB/RIF检测在糖尿病并发菌阴性肺结核患者诊断中的价值*[J].陕西医学杂志,2019,(7):885-889.
　ZHOU Yi,ZHANG Ning,LIU Xiaorong,et al.Diagnostic efficiency of T-SPOT.TB and Gen-Xpert MTB/RIF in detecting smear-negative pulmonary tuberculosis combined with diabetes mellitus.[J].,2019,(7):885-889.
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结核感染T淋巴细胞实验和Xpert MTB/RIF检测在糖尿病并发菌阴性肺结核患者诊断中的价值*
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《陕西医学杂志》[ISSN:1000-7377/CN:61-1281/TN]

卷:
期数:
2019年7期
页码:
885-889
栏目:
临床研究
出版日期:
2019-07-05

文章信息/Info

Title:
Diagnostic efficiency of T-SPOT.TB and Gen-Xpert MTB/RIF in detecting smear-negative pulmonary tuberculosis combined with diabetes mellitus.
文章编号:
DOI:10.3969/j.issn.1000-7377.2019.07.020
作者:
周 祎; 张 宁; 刘晓荣; 刘 莉
陕西省结核病防治院内五科（西安 710100）
Author(s):
ZHOU Yi; ZHANG Ning; LIU Xiaorong; et al.
The Tuberculosis Prevention and Care Hospital in Shaanxi Province(Xi’an 710100)
关键词:
糖尿病; 菌阴性肺结核; 结核抗体; 结核感染T淋巴细胞实验; Gen-XpertMTB/RIF; 快速诊断
Keywords:
Key words Diabetes mellitus;  Smear-negative pulmonary tuberculosis;  Tuberculosis antibody test;  T-SPOT.TB;  Gen-Xpert MTB/RIF;  Rapid diagnosis
分类号:
R587.2
文献标志码:
A
摘要:
摘 要 目的:探讨结核感染T淋巴细胞实验（T-SPOT.TB）与Xpert MTB/RIF检测方法在糖尿病并发菌阴性肺结核（TB）患者快速诊断中的应用价值。方法:收集糖尿病并发肺结核患者263例，对其进行结核抗体（TB-AB），T-SPOT.TB和Gen-Xpert MTB/RIF 检测。根据痰细菌学诊断结果，将患者分为糖尿病并发菌阳肺结核组和糖尿病并发菌阴肺结核组，比较三种检测方法对肺结核检出阳性率的差异以及三种方法联用后检测阳性率的变化。结果:糖尿病并发菌阳肺结核111例（42.20%），糖尿病并发菌阴肺结核152例（57.80%）。263例患者中，TB-AB、T-SPOT.TB和Gen-XpertMTB/RIF的阳性率分别为61.98%（163/263）、84.41%（222/263），和71.48%（188/263），三种方法TB阳性率比较差异具有统计学意义（χ233.544，P0.000）。152例糖尿病并发菌阴组患者中，TB-AB、T-SPOT.TB和Gen-XpertMTB/RIF的阳性率分别为59.87%（72/152）、80.92%（123/152）和67.11%（102/152）。菌阳组与菌阴组之间三种检测方法的阳性率比较，差异均无统计学意义（P＞0.05）。三种方法在不同性别和年龄段患者中检测阳性率差异无统计学意义。T-SPOT.TB与TB-AB或XpertMTB/RIF联用，糖尿病并发菌阴组阳性率均达到90%以上，而三种联用时菌阴组检测阳性率则达到94.73%。结论：T-SPOT.TB和Gen-Xpert MTB/RIF方法的检出阳性率较高，在糖尿病并发菌阴性肺结核患者的快速诊断中具有应用价值。
Abstract:
Abstract Objective:To evaluate the diagnostic efficiency of T-SPOT.TB and Gen-Xpert MTB/RIF methods in detecting smear-negative pulmonary tuberculosis (TB) in patients with diabetes mellitus. Methods: 263 patients with confirmed pulmonary tuberculosis complicated with diabetes mellitus were determined using TB antibody (TB-AB) examination, TB-SPOT and Gen-Xpert MTB/RIF approaches. Based on the smear culture results, the collected patients were divided into diabetes mellitus with smear-positive TB group and diabetes mellitus with smear negative-TB group. TB positive rate of the three measurements and the change of TB positive rate with regarding to the combination of the three measurements were compared. Results:There were 111 (42.20%) diabetes mellitus with smear-positive TB and 152 (57.80%) diabetes mellitus with smear-negative TB in the collected patients. The positive rates of TB-AB examination, TB-SPOT and Gen-Xpert MTB/RIF approaches in 263 collected patients were 61.98% (163/263), 84.41% (222/263) and 71.48% (188/263), respectively. There was no significant difference in the positive rate of TB among the three detection methods (χ233.544,P0.000). In 152 patients with smear-negative TB, the positive rate of TB-AB, T-SPOT.TB and Gen-XpertMTB/RIF detections were 59.87% (72/152), 80.92% (123/152) and 67.11% (102/152). There were no significant difference in positive rate of the three detection between smear-positive and smear-negative TB groups (P>0.05). There were no significant difference on positive rate of the three detection between sex and ages. T-SPOT.TB combined with TB-Abor XpertMTB/RIF achieved 〖LM〗a positive rate above 90% in patients with smear-negative TB, while it reached 94.73% when the three detection were combined. Conclusion:T-SPOT.TB and Gen-Xpert MTB/RIF tests showed higher positive rate of TB detection and they can be used in the rapid diagnosis of pulmonary tuberculosis in smear-negative patients with diabetes mellitus. 

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备注/Memo

备注/Memo:
*陕西省卫生健康委员会科研基金资助项目（2018-D046）
更新日期/Last Update: 2019-07-12