荧光定量聚合酶链反应检测支气管肺泡灌洗液中结核分枝杆菌脱氧核糖核酸诊断肺结核价值.docVIP

荧光定量聚合酶链反应检测支气管肺泡灌洗液中结核分枝杆菌脱氧核糖核酸诊断肺结核价值 　　【摘要】 目的 探?荧光定量聚合酶链反应（PCR）检测支气管肺泡灌洗液（BALF）结核分枝杆菌脱氧核糖核酸（TbDNA）诊断肺结核的临床价值。方法 选取51例肺结核患者作为肺结核组， 另选60例非肺结核患者作为对照组。所有患者均完善BALF TbDNA检测及毛刷涂片抗酸染色镜检、痰涂片抗酸染色镜检。以评价BALF中TbDNA检测对诊断肺结核的敏感性、特异性、阳性预测值（PPV）、阴性预测值（NPV）。结果 荧光定量PCR检测BALF中的TbDNA， 其阳性对肺结核诊断的敏感性、特异性、PPV、NPV分别为74.51%、96.67%、95.00%、81.69%， 肺结核组毛刷涂片抗酸染色镜检的敏感性为13.73%， 痰涂片抗酸染色镜检敏感性为15.69%。对照组中， 荧光定量PCR检测BALF中的TbDNA的特异性为96.67%， 毛刷涂片抗酸染色镜检及痰涂片抗酸染色镜检的特异性均为100.00%。肺结核组荧光定量PCR检测BALF中的TbDNA与痰涂片抗酸染色镜检及毛刷涂片抗酸染色镜检敏感性比较差异有统计学意义（P0.05）。结论 荧光定量PCR检测BALF中的TbDNA有良好的特异性和敏感性， 有望辅助传统的检查来早期诊断肺结核。 　　【关键词】 荧光定量聚合酶链反应；支气管肺泡灌洗液；结核分枝杆菌脱氧核糖核酸；肺结核 　　DOI：10.14163/j.cnki.11-5547/r.2018.10.007 　　【Abstract】 Objective To disucss the clinical value of fluorescence quantitative polymerase chain reaction （PCR） in detection of mycobacterium tuberculosis deoxyribonucleic acid （TbDNA） in bronchoalveolar lavage fluid （BALF） for the diagnosis of pulmonary tuberculosis. Methods There were 51 pulmonary tuberculosis patients as pulmonary tuberculosis group， and 60 non-pulmonary tuberculosis patients as control group. All patients improved BALF TbDNA detection， brush smear acid-fast staining， sputum smear acid-fast staining， so as to evaluate the sensitivity， specificity， positive predictive value （PPV） and negative predictive value （NPV） of TbDNA detection in BALF for diagnosis of tuberculosis. Results TbDNA in BALF was detected by fluorescence quantitative PCR， and the sensitivity， specificity， PPV and NPV of the positive pulmonary tuberculosis were 74.51%， 96.67%， 95% and 81.69% respectively. In the pulmonary tuberculosis group， the sensitivity of brush smear acid-fast staining was 13.73%， and the sensitivity of sputum smear acid-fast staining was 15.69%. In the control group， the specificity of fluorescence quantitative PCR for detection of TbDNA in BALF was 96.67%. The specificity of brush smear acid-fast staining and sputum smear acid-fast staining were 100.00%. In the pulmonary tuberculosis group， there was stati