您的位置: 首页 > 2024年1月 第55卷 第1期 > 文字全文
2023年7月 第38卷 第7期11
目录

五种检测技术在尘肺合并肺结核诊断中的应用价值

The application value of five testing techniques in the diagnosis of pneumoconiosis combined with pulmonary tuberculosis

来源期刊: 广州医药 | 30-34 发布时间:2024-01-24 收稿时间:2025/11/13 18:51:33 阅读量:93
作者:
关键词:
尘肺肺结核Xpert MTB/RIFTB-IGRA分枝杆菌菌种鉴定
pneumoconiosispulmonary tuberculosisXpert MTB/RIFTB-IGRAidentification of Mycobacterium species
DOI:
10.3969/j.issn.1000-8535.2024.01.005
收稿时间:
2023-07-24 
修订日期:
 
接收日期:
 
引用总数:
0  
目的 探讨痰涂片找抗酸杆菌、痰利福平耐药实时荧光定量核酸扩增检测技术(Xpert MTB/RIF)、分枝杆菌菌种鉴定、痰抗酸杆菌培养和血γ-干扰素释放检测技术(TB-IGRA)5种检测技术在尘肺合并肺结核临床诊断中的应用价值。方法 纳入2016年7月—2021年5月在厦门大学附属第一医院住院治疗的尘肺合并肺结核患者,按照尘肺患者是否合并肺结核,将患者分为尘肺组(156例)和尘肺合并肺结核组(111例);比较两组患者的性别、年龄、接尘时间等一般资料,以及患者痰涂片、Xpert MTB/RIF、分枝杆菌菌种鉴定、痰培养和TB-IGRA的检测结果,分析尘肺合并肺结核患者5种检测技术阳性检出率的差异及其诊断价值。结果 在尘肺合并肺结核组中,TB-IGRA检测方法的阳性检出率最高(81.1%),高于其他4种检测方法(P<0.01);两两联合检测,以Xpert MTB/RIF+TB-IGRA组合的检测方式检出率最高(96.4%),高于其他9种组合(P<0.01)。结论 TB-IGRA检测方法对尘肺合并肺结核患者的阳性检出率较高,联合Xpert MTB/RIF检测后可进一步提高诊断效率,对早期诊断尘肺是否合并结核具有重要的临床诊断价值。
Objective To investigate the value of five testing techniques in the clinical diagnosis of pneumoconiosis combined pulmonary tuberculosis,including sputum smear,Xpert Mycobacterium tuberculosis/rifampicin(Xpert MTB/RIF),identification of Mycobacterium species,sputum acid-fast bacilli culture and tuberculosis-interferon-gamma release assays(TB-IGRA).Methods Patients with pneumoconiosis combined with tuberculosis who were hospitalized in the First Hospital of Xiamen University from July 2016 to May 2021 were included in the study.The patients were divided into the pneumoconiosis group(156 cases)and pneumoconiosis combined with tuberculosis group(111 cases)according to whether the pneumoconiosis patients were combined with tuberculosis or not.The general data of the patients in the two groups were compared with respect to gender,age,and dust exposure time,and the results of sputum smears,Xpert MTB/RIF,identification of Mycobacterium species,sputum acid-fast bacilli culture and TB-IGRA were collected to analyze the differences and the diagnostic value in the five testing techniques of the positivity rates for patients who have pneumoconiosis combined with pulmonary tuberculosis.Results In the group with pneumoconiosis combined with tuberculosis,the positive detection rate of TB-IGRA was the highest(81.1%),which was higher than other 4 testing methods(P<0.01).Combined testing in pairs suggested that the testing method of Xpert MTB/RIF and TB-IGRA combination was the highest(96.4%),significantly higher than the other 9 combinations(P<0.01).Conclusions TB-IGRA has higher positive detection rate for patients with pneumoconiosis combined with tuberculosis,and diagnostic efficiency can be further improved by combining Xpert MTB/RIF assay testing,which is of great clinical diagnostic value for the early diagnosis of pneumoconiosis combined with tuberculosis.
1、 STEINGART K R,SCHILLER I,HORNE D J,et al.Xpert?MTB/RIF assay for pulmonary tuberculosis and rifampicin resistance in adults[J].Cochrane Database Syst Rev,2014,21(1):CD009593. STEINGART K R,SCHILLER I,HORNE D J,et al.Xpert?MTB/RIF assay for pulmonary tuberculosis and rifampicin resistance in adults[J].Cochrane Database Syst Rev,2014,21(1):CD009593.
2、 王华,甄拴平,高涛.结核感染T细胞γ干扰素释放试验(TB-IGRA)在结核病诊断中的应用[J].临床医学研究与实践,2018,3(25):97-98. 王华,甄拴平,高涛.结核感染T细胞γ干扰素释放试验(TB-IGRA)在结核病诊断中的应用[J].临床医学研究与实践,2018,3(25):97-98.
3、 单颖,赵雪梅,王文明,等.Xpert MTB/RIF检测技术在尘肺合并肺结核诊断中的应用价值分析[J].预防医学情报杂志,2020,36(9):1136-1139. 单颖,赵雪梅,王文明,等.Xpert MTB/RIF检测技术在尘肺合并肺结核诊断中的应用价值分析[J].预防医学情报杂志,2020,36(9):1136-1139.
4、 DATTA S,SHAH L,GILMAN R H,et al.Comparison of sputum collection methods for tuberculosis diagnosis:A systematic review and pairwise and network meta-analysis[J].Lancet Glob Health,2017,5(8):e760-e771. DATTA S,SHAH L,GILMAN R H,et al.Comparison of sputum collection methods for tuberculosis diagnosis:A systematic review and pairwise and network meta-analysis[J].Lancet Glob Health,2017,5(8):e760-e771.
5、 SKOWRO?SKI M,HALICKA A,BARINOW-WOJEWóDZKi A.Pulmonary tuberculosis in a male with silicosis[J].Adv Respir Med,2018,86(3). SKOWRO?SKI M,HALICKA A,BARINOW-WOJEWóDZKi A.Pulmonary tuberculosis in a male with silicosis[J].Adv Respir Med,2018,86(3).
6、 HU M,WANG Z,HU X,et al.High-resolution computed tomography diagnosis of pneumoconiosis complicated with pulmonary tuberculosis based on cascading deep supervision U-Net[J].Comput Meth prog Bio,2022(226):107151. HU M,WANG Z,HU X,et al.High-resolution computed tomography diagnosis of pneumoconiosis complicated with pulmonary tuberculosis based on cascading deep supervision U-Net[J].Comput Meth prog Bio,2022(226):107151.
7、 ALMBERG K S,FRIEDMAN L S,ROSE C S,et al.Progression of coal workers’ pneumoconiosis absent further exposure[J].Occup Environ Med,2020,77(11):748-751. ALMBERG K S,FRIEDMAN L S,ROSE C S,et al.Progression of coal workers’ pneumoconiosis absent further exposure[J].Occup Environ Med,2020,77(11):748-751.
8、 WANG T,SUN W,WU H,et al.Respiratory traits and coal workers’ pneumoconiosis:Mendelian randomisation and association analysis[J].Occup Environ Med,2021,78(2):137-141. WANG T,SUN W,WU H,et al.Respiratory traits and coal workers’ pneumoconiosis:Mendelian randomisation and association analysis[J].Occup Environ Med,2021,78(2):137-141.
9、 HALL N B,BLACKLEY D J,HALLDIN C N,et al.Current review of pneumoconiosis among US coal miners[J].Curr Environ Health Rep,2019,6(3):137-147. HALL N B,BLACKLEY D J,HALLDIN C N,et al.Current review of pneumoconiosis among US coal miners[J].Curr Environ Health Rep,2019,6(3):137-147.
10、 中华人民共和国国家卫生和计划生育委员会.肺结核诊断标准(WS 288-2017)[J].新发传染病电子杂志,2018,3(1):59-61. 中华人民共和国国家卫生和计划生育委员会.肺结核诊断标准(WS 288-2017)[J].新发传染病电子杂志,2018,3(1):59-61.
11、 职业性尘肺病的诊断:GBZ 70-2015[S].2015. 职业性尘肺病的诊断:GBZ 70-2015[S].2015.
12、 KENAOPE L,FERREIRA H,SEEDAT F,et al.Sputum culture and drug sensitivity testing outcome among X-pert Mycobacterium tuberculosis/rifampicin-positive,rifampicin-resistant sputum:A retrospective study - Not all rifampicin resistance is multi-drug resistant[J].J Glob Antimicrob Resist,2020(21):434-438. KENAOPE L,FERREIRA H,SEEDAT F,et al.Sputum culture and drug sensitivity testing outcome among X-pert Mycobacterium tuberculosis/rifampicin-positive,rifampicin-resistant sputum:A retrospective study - Not all rifampicin resistance is multi-drug resistant[J].J Glob Antimicrob Resist,2020(21):434-438.
13、 WAGNEW F,ALENE K A,KELLY M,et al.The effect of undernutrition on sputum culture conversion and treatment outcomes among people with multidrug-resistant tuberculosis:A systematic review and meta-analysis[J].Int J Infect Dis,2023(127):93-105. WAGNEW F,ALENE K A,KELLY M,et al.The effect of undernutrition on sputum culture conversion and treatment outcomes among people with multidrug-resistant tuberculosis:A systematic review and meta-analysis[J].Int J Infect Dis,2023(127):93-105.
14、 LUO W,LIN Y,LI Z,et al.Comparison of sputum induction and bronchoscopy in diagnosis of sputum smear-negative pulmonary tuberculosis:A systemic review and meta-analysis[J].BMC Pulm Med,2020,20(1):146. LUO W,LIN Y,LI Z,et al.Comparison of sputum induction and bronchoscopy in diagnosis of sputum smear-negative pulmonary tuberculosis:A systemic review and meta-analysis[J].BMC Pulm Med,2020,20(1):146.
15、 SU X,KONG X,YU X,et al.Incidence and influencing factors of occupational pneumoconiosis:A systematic review and meta-analysis[J].BMJ Open,2023,13(3):e065114. SU X,KONG X,YU X,et al.Incidence and influencing factors of occupational pneumoconiosis:A systematic review and meta-analysis[J].BMJ Open,2023,13(3):e065114.
16、 QI X M,LUO Y,SONG M Y,et al.Pneumoconiosis:Current status and future prospects[J].Chin Med J(Engl),2021,134(8):898-907. QI X M,LUO Y,SONG M Y,et al.Pneumoconiosis:Current status and future prospects[J].Chin Med J(Engl),2021,134(8):898-907.
上一篇
下一篇
出版者信息








《广州医药》公众号
目录