目的 研究集体呼吸操对慢阻肺稳定期患者的执行率影响效果。方法 选取连州市人民医院呼吸内科、ICU 2019年6月—2020年6月收治的120例慢阻肺稳定期患者为研究对象,以随机数字表法分为试验组与对照组,每组各60例,对照组采取一对一训练,试验组采取集体呼吸操,对两组执行率、肺功能、六分钟步行距、圣乔治呼吸问卷(St. George's Respiratory Questionnaire Application,SGRQ)评分进行对比。结果 试验组执行率90.00%,与对照组75.00%相比较,差异有统计学意义(P＜0.05);护理前两组肺功能、六分钟步行距离、SGRQ评分相比较,差异无统计学意义(P＞0.05),护理后4周、护理后8周与护理前相比较,差异有统计学意义(P＜0.05); 试验组护理后4周、护理后8周肺功能、六分钟步行距、SGRQ评分与对照组相比较,差异有统计学意义(P＜0.05)。结论 集体呼吸操有助于提高慢阻肺稳定期患者执行率,进一步改善其肺功能以及运动耐力水平,值得在今后护理工作中推广使用。

Objective To study the effect of collective breathing exercises on the execution rate of patients with stable COPD. Methods A total of 120 patients with stable chronic obstructive pulmonary disease admitted to the department of respiratory medicine and ICU of Lianzhou People's Hospital from June 2019 to June 2020 were selected as the research objects. They were divided into the experimental group and the control group by a random number table. For 60 cases, the control group took one-to-one training, and the test group took collective breathing exercises. The performance rate, lung function, six-minute walk distance, and St. George's Respiratory Questionnaire Application (SGRQ) scores were compared between the two groups. Results The execution rate of the experimental group was 90.00%, compared with 75.00% of the control group, the difference was statistically significant (P<0.05); there was no statistically differences in lung function, six-minute walking distance, and SGRQ score between the two groups before nursing ( P>0.05), 4 weeks after nursing, 8 weeks after nursing, and before nursing, the difference was statistically significant (P<0.05); in the experimental group, 4 weeks after nursing, 8 weeks after nursing, lung function, six-minute walking distance, SGRQ score was compared with the control group, the difference was statistically significant (P<0.05). Conclusion Group breathing exercises may help improve the performance rate of patients with chronic obstructive pulmonary disease in stable phase, and further improve their lung function and exercise endurance. It is worth popularizing in future nursing work.

目的 探讨体外受精治疗中第3天(D3)不同质量卵裂期胚胎培养至囊胚的发育潜能,为囊胚培养提供实验室依据。方法 对2015年4月—2019年4月D3移植或冷冻后剩余行囊胚培养的5 510枚胚胎进行了回顾性分析。按D3胚胎质量、卵裂球数目、均一性及碎片率分组,比较囊胚形成率,优质囊胚形成率及可利用囊胚形成率,并分析各因素与可利用囊胚形成的相关性。结果 D3优质胚胎的囊胚形成率,优质囊胚形成率及可利用囊胚形成率与非优质胚胎组相比有统计学差异(P＜0.05);4-6细胞组及＜4细胞组与7-9细胞组相比有统计学差异(P＜0.05),但融合期胚胎(CP)组及＞ 9细胞组与7-9细胞组相比差异无统计学意义;卵裂球大小差异(+)组和(++/+++)组与卵裂球大小均匀(-)相比有统计学差异(P＜0.05); 10%～25%组及碎片＞25%组与碎片≤10%组相比有统计学差异(P＜0.05)。 Logistic分析结果表明,D3胚胎质量、卵裂球数目、均一性及胚胎碎片率与可利用囊胚形成显著相关(P＜0.05)。 结论 D3胚胎质量、卵裂球数目、均一性及胚胎碎片均会影响到囊胚的形成及质量,其中胚胎质量和卵裂球数目对可利用囊胚形成的影响较大。

Objective To explore the developmental potential of day 3(D3) different quality embryos cultured to blastocyst in vitro fertilization treatment, and to provide laboratory basis for blastocyst culture. Methods A total of 5 510 embryos with blastocyst culture remained after D3 transplantation or freezing from April 2015 to April 2019 were analyzed retrospectively. They were divided into groups according to embryo quality, blastomere number, blastomere homogeneity and fragment rate in D3. And the blastocyst formation rate, high quality blastocyst formation rate and available blastocyst formation rate were compared between the groups.The correlation within each factor and available blastocyst formation was analyzed. Results The blastocyst formation rate, high quality blastocyst formation rate and available blastocyst formation rate of D3 high quality embryo group were higher than those of non-high quality embryo group (P<0.05); compared with 7- 9 cell group, 4- 6 cell group and<4 cell group were lower (P<0.05), but there was no significant difference in CP group or >9 cell group. Compared with the normal size of the blastomere (-), the difference in the size of the blastomere (+) group and the (++/+++) group decreased (P<0.05); compared with the fragment ≤ 10%, the difference in the size of the blastomere between the 10%~25% group and the fragment>25% group decreased (P<0.05). The results of logistic analysis suggested that the embryo quality, blastomere number, homogeneity and fragment rate of D3 were correlated with available blastocyst formation (P<0.05). Conclusion D3 embryo quality, blastomere number, homogeneity and embryo fragment may affect the formation and quality of blastocyst, especially the embryo quality and blastomere number.

目的 探讨健康儿童的个体因素对超声测量下腔静脉内径的影响。方法 使用超声测量210例健康儿童的下腔静脉呼气末内径及腹主动脉内径,并记录他们的个体特征,包括性别、年龄、身高、体质量、腰围、体表面积等,进行相关与回归分析。结果 年龄、身高、体质量、腰围、体表面积与下腔静脉和腹主动脉内径呈正相关。年龄是女性儿童下腔静脉内径唯一的独立影响因素,身高是男性儿童下腔静脉内径唯一的独立影响因素。无论男性或女性,年龄是儿童腹主动脉内径的独立影响因素,而下腔静脉和腹主动脉内径的比值不受这些个体因素的影响。结论 下腔静脉和腹主动脉内径易受个体因素影响,而它们的比值不易受个体因素影响,可以更好的用于预测儿童的容量特征。

Objective To explore the impact of individual characteristics on inferior vena cava diameter ( IVC ) in healthy children. Methods IVC_max and abdominal aorta (AO) diameters were measured by ultrasound in 210 healthy children. The individual characteristics including gender, age,height,weight, waist circumference of each child were recorded. Then the surface area(BSA) and IVC_max/AO were calculated to discuss the relationship between them with multivariate analysis. Results Age, height, weight,waist circumference, and BSA were positively correlated with IVC_max and AO. Multivariate linear regression showed that age was the only independent variable for IVC_max in female children, height was the only independent variable for IVC_max in male children, and age was the only independent variable for AO in both females and males. IVC_max/AO was not significantly influenced by the subjects' characteristics. Conclusion IVC_max and AO were more susceptible to subjects' characteristics than IVC_max/AO. IVC_max/AO could be a reliable and practical parameter in children as it was independent of age, height, and weight.

目的 探讨家庭医生契约式服务对婴儿生长发育及肺炎发生率的影响。方法 选取2019年7月—2020年2月龙凤社区出生的婴儿200例作为研究对象,随机分为签约组与未签约组,每组100例。其中,签约组婴儿接受家庭医生契约式服务,未签约组婴儿则接受社区常规儿童保健服务。记录两组婴儿出生后第1、3、6、9、12个月时的生长发育指标(身长、体质量)、神经心理发育指标(大动作、精细动作、个人-社会、语言、适应性)以及肺炎发生率,进行对比分析。结果 出生后第1个月和第3个月,两组婴幼儿身高与体质量差异无统计学意义(P＞0.05)。自出生后第6个月开始,签约组婴幼儿的身高与体质量水平均高于未签约组婴幼儿(P＜0.05)。两组中出生后1月龄的婴幼儿在发育商5项指标中差异均无统计学意义(P＞0.05)。在12月龄时,签约组婴幼儿的大动作、精细动作、个人-社会、语言、适应性5项指标评分均高于未签约组婴幼儿(P＜0.05)。截止出生后第12个月,签约组共发生2例肺炎患儿,肺炎发生率2%;未签约组发生10例肺炎患儿,肺炎发生率10%,高于签约组肺炎发生率。所有肺炎患儿均给予积极对症治疗后痊愈。结论 家庭医生契约式服务能够促进婴幼儿出生后第1年内身心发育水平,同时还能有效降低肺炎的发生风险,有利于婴幼儿身心全面、健康地发育和生长,具有比较显著的卫生和社会学价值,值得推广应用。

Objective To explore the effect of family doctor contract service on infant growth and development and incidence of pneumonia. Methods From July 2019 to February 2020, 200 infants in Longfeng community were selected as the research objects and randomly divided into contract group and non contract group, with 100 cases in each group. Among them, the infants in the contract group received the family doctor contract service, while the infants in the non signing group received the community routine child health care services. The growth and development indexes (body length, body weight), neuropsychological development indexes (big movements, fine movements, personal society, language, adaptability) and the incidence of pneumonia were recorded and analyzed in the first, third, sixth, ninth and twelfth months after birth. Results There were no significant differences in height and weight between the two groups at the first and third month after birth (P>0.05). From the 6th month after birth, the height and weight of infants in the signing group were higher than those in the non signing group (P<0.05). There were no significant differences in the 5 indexes of development quotient between the two groups (P>0.05). At the age of 12 months, the scores of big movement, fine movement, personal society, language and adaptability of infants in contract group were higher than those in non contract group (P<0.05). By the end of the 12th month after birth, there were 2 cases of pneumonia in the signing group, the incidence of pneumonia was 2%; in the non signing group, there were 10 cases of pneumonia, the incidence of pneumonia was 10%, which was higher than that of the signing group. All children with pneumonia were cured after active symptomatic treatment. Conclusion Family doctor contract service can promote the physical and mental development level of infants and young children in the first year after birth, at the same time, it can effectively reduce the risk of pneumonia, which is conducive to the comprehensive and healthy development and growth of infants and young children. It has significant health and sociological value and is worthy of promotion and application.

目的 分析晚期三阴性乳腺癌(TNBC)的危险因素并建立有效的预后列线图。方法 通过检索美国SEER(surveillance, epidemiology, and end results)数据库筛选晚期TNBC患者,采用单因素和多因素分析来确定晚期TNBC的独立预后因素,并以此构建了列线图,通过校准曲线检验和C指数(C-index)评估已建立的列线图。结果 共纳入4 687例晚期TNBC患者,与同期其他分子分型的乳腺癌相比较,TNBC的预后最差。单因素分析发现,年龄、性别、分期、手术、化疗、放疗、转移与更好的预后相关(P<0.05)。多因素分析发现年龄、性别、种族、分期、手术、化疗、放疗、各器官转移是患者预后的独立影响因素(P<0.05),并以此构建了列线图,其C-index为0.75(95％CI,0.71～0.79),校准图显示了预测的总生存期(OS)与观察到的OS之间的最佳一致性。结论 我们分析了晚期TNBC的临床特征,为TNBC患者的OS提供了一些预后因素,并根据这些预后因素制定了列线图,帮助临床医生进行风险管理并选择TNBC患者的长期生存策略。

Objective To analyze the risk factors of advanced triple-negative breast cancer (TNBC) and establish an effective prognostic nomogram. Methods Screening patients with advanced TNBC by searching the SEER (surveillance, epidemiology, and end results) database, using univariate and multivariate analysis to determine the independent prognostic factors of advanced TNBC, and constructing a nomogram based on it. Results A total of 4 687 patients with advanced TNBC were included. Compared with other types of breast cancer over the same period, TNBC had the worst prognosis. Univariate analysis found that age, gender, stage, surgery, chemotherapy, radiotherapy, and metastasis were associated with a better prognosis (P<0.05). Multivariate analysis found that age, gender, race, stage, surgery, chemotherapy, radiotherapy, and metastasis of the organs were independent factors affecting the prognosis of patients (P<0.05), and constructed a nomogram with a C-index of 0.75 ( 95% CI, 0.71～0.79). The calibration chart showed the best agreement between the predicted overall survival (OS) and the observed OS. Conclusion We analyzed the clinical features of advanced TNBC, provided some prognostic factors for the OS of TNBC patients, and developed a nomogram based on these prognostic factors to help clinicians manage risk and choose long-term survival strategies for TNBC patients.

目的 观察香芹酚的解酒护肝作用。方法 将实验小鼠随机分为实验组(低剂量香芹酚组,中剂量香芹酚组,高剂量香芹酚组),生理盐水对照组和阳性对照组,观察小鼠行为学,醉酒小鼠的醉酒时间和醉酒潜伏期,检测血液中的乙醇浓度和肝组织中的SOD和MDA,计算肝比重。结果 与实验组比较,低,中,高剂量组香芹酚分别能显著延长小鼠的醉酒潜伏期(P<0.05),同时,各剂量的香芹酚组均可使肝组织中丙二醛(MDA)含量降低(P<0.05),肝组织中超氧化物歧化酶(SOD)活性分别增加(P<0.05)。结论 香芹酚具有解酒护肝作用,其作用机理可能与抗氧化活性有关。

Objective To observe the effect of carvacrol on MDA and SOD in acute alcoholic liver injury. Methods The experimental mice were randomly divided into the experimental group (low-dose carvacrol group, medium-dose carvacrol group, high-dose carvacrol group), normal saline control group and positive control group. The behavior of the mice was observed, the time and incubation period of drunkenness of the mice were observed, the concentration of alcohol in blood and SOD and MDA in liver tissues were detected, and the specific gravity of the liver was calculated. Results Compared with the experimental group, carvacrol in the low, medium and high dose groups could prolong the intoxication incubation period of mice (P<0.05), meanwhile, the content of malonaldehyde (MDA) in liver tissues was reduced in the carvacrol group (P<0.05), and the activity of superoxide dismutase (SOD) in liver tissues was increased in the carvacrol group (P<0.05). Conclusion Carvacrol has antialcoholism and liver protecting effects, and its mechanism may be related to antioxidant activity.

目的 观察新疆石河子地区绝经后女性2型糖尿病(T2DM)患者糖、脂、骨代谢特征及骨密度(BMD)情况,探讨该人群中低密度脂蛋白受体相关蛋白5(LRP5)基因rs3736228、rs3781586位点的基因多态性及突变与糖、脂、骨代谢指标的关系。方法 将新疆石河子地区2016年10月—2017年10月社区、医院门诊及住院绝经后女性按照纳入标准和排除标准选取136例为研究对象,根据患者病史、糖耐量实验及骨密度仪测定骨密度分4组,糖耐量正常与骨量正常组(A组),糖耐量正常与骨量异常组(B组),T2DM与骨量正常组(C组),T2DM与骨量异常组(D组)。测定并记录患者年龄、绝经年限等基线资料,计算体质指数(BMI)等,并检测糖代谢指标(空腹血糖等)、骨代谢指标(血Ca等)、脂代谢指标(甘油三酯等)。采用MALDI-TOF-MS法测定LRP5基因该两个位点基因多态性并进行统计分析。结果 ①糖代谢指标:与A组比较,C组、D组FPG、HbA1c均高于A组(P<0.01)。脂代谢指标:与A组比较,B组、D组TG低于A组(P<0.05)。骨代谢指标:与A组比较,B组、D组BMD(L1-4)、BMD(股骨颈)低于A组(P<0.01)。②LRP5基因该两个位点SNP基因分型分布符合Hardy-Weinberg遗传平衡定律(P>0.05);同时,该两个位点不同基因型的分布频率和等位基因频率在组间的比较经Pearson Chi-Square检验后发现暂无显著差异(P>0.05)。③LRP5基因rs3736228位点:A组,与CC型(野生型)相比,CT/TT型(突变型)甘油三酯(TG)降低(P<0.05),BMD(L1-4)降低(P<0.05);C组,与CC型(野生型)相比,CT/TT型(突变型)高密度脂蛋白(HDL-C)升高(P<0.01),磷(P)升高(P<0.05);LRP5基因rs3781586位点:B组,与GG型(野生型)相比,GT/TT(突变型)高密度脂蛋白(HDL-C)升高(P<0.05)。结论 在新疆石河子地区绝经后女性2型糖尿病人群中,LRP5基因rs3736228、rs3781586位点的基因多态性可能与糖代谢无关,但LRP5基因rs3736228位点的突变可能与脂代谢(TG、HDL-C)、骨代谢(P、BMD)有关,rs3781586位点的突变可能与脂代谢(HDL)有关。

Objective To observe the characteristics of glucose, lipid and bone metabolism and bone mineral density (BMD)in postmenopausal women with type 2 diabetes mellitus (T2DM)in Shihezi district of Xinjiang province, and to investigate the relationship in the polymorphism and mutation of rs3736228 and rs3781586 of LRP5 gene and glucose,lipid and bone metabolism indexes in this population. Method A total of 136 postmenopausal Han women, who were related in the outpatient department, community, and hospital after hospitalization in Shihezi district of Xinjiang province from October 2016 to October 2017, were selected as the study subjects by the inclusion criteria and exclusion criteria.According to the patient's medicalhistory, glucosetolerance test results and bone mineral density (BMD), they were divided into 4 groups: normal glucose tolerance and normal bone mass (group A), normal glucose tolerance and abnormal bone mass (group B), type 2 diabetes and normal bone mass (group C), and type 2 diabetes mellitus and abnormal bone mass (group D). Baseline data such as patient's age, menopause years were measured and recorded, and body mass index (BMI)was calculated. Simultaneously, glucose metabolism indicators including fasting blood glucose (FBG, etc), bone metabolism indicators (blood Ca, etc), lipid metabolism indicators(triglycerides, etc)were detected. The polymorphisms of rs3736228 and rs3781586 of LRP5 gene were determined by Maldi-Tof-Ms and those data were analyzed statistically. Results ①Glucose metabolism index: compared with group A: FPG and HbAlc in group C, group D were all higher than group A (P<0.01). Lipid metabolism index: compared with group A, TG in group B and group D was lower than that in group A (P<0.05). Bone metabolism index: compared with group A, BMD (L1- 4)and BMD (femoral neck)in group B and group D were lower than those in group A (P<0.01). ②The distribution of SNP genotypes at rs3736228, rs3781586 of LRP5 conformsed to the Hardy-Weinberg genetic equilibrium law (P>0.05). The distribution frequency and allele frequency of LRP5 genotypes rs3736228, rs3781586 were compared among the groups. Pearson chi-square test showed no significant difference (P>0.05). ③Rs 3736228 locus of LRP5 gene:in group A, compared with CC (wild type), CT/TT (mutated type)triglyceride (TG)decreased (P<0.05), BMD (L1- 4)decreased (P<0.05). In group C, compared with CC (wild type), CT/TT (mutated type)high-density lipoprotein (HDL-C)increased (P<0.05), phosphorus increased (P<0.05). Rs 3781586 locus of LRP5 gene: in group B, compared with GG (wild type), GT/TT (mutated type)high-density lipoprotein (HDL-C)increased (P<0.05).Conclusion In the Xinjiang Shihezi district among postmenopausal women with type 2 diabetes, rs3736228, rs3781586 loci of LRP5 gene polymorphism may be irrelevant to glucose metabolism, but the mutation of rs3736228 of LRP5 gene locus may be related to lipid metabolism and bone metabolism (TG, HDL-C, BMD, P), and the mutation of rs3781586 may be related to lipid metabolism (HDL-C).

目的 探讨应用超声心动图评价肺动脉高压(PAH)致心肌损伤的临床价值及氧化应激损伤的相关性。方法 12周龄SD大鼠48只。随机均分为4组:空白对照组、NaCl对照组、PAH 2周组及PAH 4周组。建模后,采用超声检测相关参数。HE及Masson染色观察右心室的心肌细胞及胶原纤维分布情况,测定超氧化物歧化酶(SOD)活力,还原型谷胱甘肽(GSH)和丙二醛(MDA)水平,并评价其与超声参数的相关性。结果 PAH组大鼠超声相关参数均变化明显,且逐渐加重。HE及Masson染色显示心肌细胞增大,心肌间隙中的胶原纤维明显增多,且4周组较明显。PAH组大鼠心肌组织中的SOD活力及GSH水平较低,而MDA水平较高,有变化趋势,且与超声参数有显著相关性,差异均有统计学意义(P<0.05)。结论 PAH导致大鼠右心室心肌组织结构改变,同时引起氧化应激相关指标的变化。

Objective To explore the clinical value of echocardiographic evaluation of myocardial injury caused by pulmonary hypertension (PAH) and the correlation of oxidative stress injury. Methods Forty-eight 12-week-old SD rats were collected. They were randomly divided into 4 groups: blank control group, NaCl control group, PAH 2-week group and PAH 4-week group. After modeling, ultrasound was used to detect relevant parameters. HE and Masson staining were used to observe the distribution of myocardial cells and collagen fibers in the right ventricle. Superoxide dismutase (SOD) activity, reduced glutathione (GSH) and malondialdehyde (MDA) levels were measured, and their correlations with ultrasound parameters were evaluated. Results The ultrasound-related parameters of rats in the PAH group changed significantly and gradually increased.HE and Masson staining showed that cardiac myocytes were enlarged and collagen fibers in myocardial interstices were increased, and it was more obvious in the 4-week group.In the PAH group, the SOD activity and GSH levels were lower, while the MDA levels were higher, and there was a trend of change, and there was a significant correlation with ultrasound parameters. The difference was statistically significant (P<0.05). Conclusion PAH causes changes in the myocardial tissue structure of the rat right ventricle, as well as changes in oxidative stress-related indicators.

目的 了解广州市属医院儿科医生职业倦怠的现状及其社会支持的相关性,对儿科医生的职业倦怠干预提供参考依据。方法 采用职业倦怠量表和社会支持评定量表对广州市属医院儿科医生进行方便抽样调查,并运用Excel和SPSS 25.0对调查结果进行统计描述、方差分析和相关分析。结果 广州市属医院370名儿科医生中共有272人(73.51%)出现不同程度的职业倦怠,中度倦怠者居多,为117人(31.62%)。职业倦怠三个维度中情感耗竭维度得分最高,为(21.64±7.17)分;社会支持总分为(37.68±8.24)分,客观支持、主观支持、支持利用维度得分分别为(7.71±3.23)、(22.53±5.03)、(7.44±1.92)分。其中社会支持处于水平低者居多,为227人(61.35%)。职业倦怠各维度和社会支持各维度两两之间均呈负相关。结论 广州市属医院儿科医生存在较严重的职业倦怠状况,社会支持状况大多处于低水平,尤其客观支持状况较差。社会支持水平越高,职业倦怠程度越轻,提示在缓解职业倦怠时应当充分考虑社会支持对其职业倦怠的影响作用。

Objective By understanding the current situation of job burnout of pediatricians in Guangzhou municipal hospitals and the correlation of social support, to provide reference basis for pediatricians to intervene in job burnout. Methods The Burnout Inventory and the Social Support Rating Scale were used for pediatricians in Guangzhou municipal hospitals, and Excel and SPSS 25.0 were used to conduct statistical description, variance analysis and correlation analysis of the survey results. Results There were 272 pediatricians (73.51%) showed different degrees of job burnout of the 370 pediatricians in Guangzhou municipal hospitals, among which 117 pediatricians (31.62%) showed moderate burnout. Among the three dimensions of job burnout, the highest score was emotional exhaustion (21.64±7.17). The total score of social support was (37.68±8.24), and the dimensions of the objective support, the subjective support and the utilization of support were (7.71±3.23), (22.53±5.03), (7.44±1.92), respectively. Among them 227 (61.35%) had low level of social support. Additionally, there was a negative correlation between each dimension of job burnout and each dimension of social support. Conclusion Pediatricians in Guangzhou municipal hospitals have more serious job burnout, and most of them have low level of social support, especially poor objective support. The higher level of social support will have the lower degree of job burnout. It suggests that the impact of social support on job burnout should be fully considered for alleviating job burnout.

目的 通过研究统计痰TB-DNA、痰分枝杆菌核酸、痰涂片找抗酸杆菌、血清T-SPOT.TB试验对肺结核的诊断敏感度、特异度、诊断预测值、诊断准确率,进一步探讨不同临床检测方法对肺结核的诊断价值,指导肺结核患者的临床诊治。方法 通过回顾性分析我院2017年1月—2019年12月呼吸内科、感染性疾病科诊断为活动性肺结核的患者,以痰结核菌培养结果为对照标准,分别统计出痰TB-DNA、痰分枝杆菌核酸、痰涂片找抗酸杆菌、血T-SPOT.TB试验对肺结核的诊断敏感度、特异度、阳性预测值、阴性预测值、诊断准确率,探讨我院临床上四种实验室方法对诊断肺结核的临床价值。结果 通过上述方法统计出痰TB-DNA、痰分枝杆菌核酸、痰涂片找抗酸杆菌、血T-SPOT.TB试验对肺结核的诊断敏感度分别是84.7%、88.1%、74.7%、96.0%,特异度分别是65.3%、69.2%、86.5%、17.8%,阳性预测值分别是83.0%、85.%、92.0%、70.7%,阴性预测值分别是68.1%、73.5%、62.1%、68.4%,诊断准确率分别是78.2%、82.0%、78.5%、70.5%。结论 跟传统方法痰结核菌培养、痰涂片找抗酸杆菌比较,TB-DNA、分枝杆菌核酸、TB-SPOT.TB试验在时效、灵敏度方面更具优势,能敏感检测出人体是否感染肺结核,对患者的早期诊断及指导治疗具有重要意义。

Objective To investigate the diagnostic sensitivity, specificity, predictive value and diagnostic accuracy of TB-DNA, mycobacterium sputum nucleic acid, acid-fast bacilli on sputum smear and serum T-SPOT.TB test for tuberculosis, so as to further explore the significance of different clinical detection methods for tuberculosis and guide the clinical diagnosis and treatment of tuberculosis patients. Methods By retrospective analysis of January 2017-December 2019, patients from respiratory medicine, infectious diseases departments diagnosed with active tuberculosis, sputum culture results of tuberculosis bacterium as control standard, we figured out sputum TB-DNA, sputum mycobacterium nucleic acid blood, sputum smear for acid fast bacilli, T-SPOT. TB test to the diagnosis sensitivity, specific degree, positive predictive value, negative predictive value, diagnostic accuracy, to explore the clinical value of four clinical laboratory methods in our hospital. Results According to the above methods, the diagnostic sensitivity of sputum TB-DNA, sputum mycobacterial nucleic acid, sputum acid-fast bacilli on smear and blood T-SPOT.TB test for tuberculosis was 84.7%、88.1%、74.7%、96.0%, and the specificity was 65.3%、69.2%、86.5%、17.8%, respectively. The positive predictive value was 83.0%、86.6%、92.0%、70.7%, and the negative predictive value was 68.1%、73.5%、62.1%、68.4%, respectively. The diagnostic accuracy was 78.2%、82.0%、78.5%、70.5%, respectively. Conclusion Compared with the traditional methods of culture and sputum smear for acid-fast bacilli, TB-DNA, mycobacterial nucleic acid and T-SPOT.TB test had more advantages in terms of timeliness and sensitivity. It is great significance for the early diagnosis and treatment of patients to detect whether they are infected with tuberculosis sensitively.