摘要
目的探讨胸水腺苷脱氨酶(ADA)联合痰结核分支杆菌/利福平耐药实时荧光定量核酸扩增技术(Xpert MTB/RIF)检测对结核性胸膜炎的诊断价值及胸水ADA取不同临界值的诊断价值。方法选取2019年4月至12月在广西玉林市红十字会医院就诊的胸腔积液患者152例,根据CT/病检检查结果分为结核性胸腔积液组(试验组)和非结核性胸腔积液组(对照组)。入院后进行胸水ADA和痰Xpert MTB/RIF检测,比较胸水ADA和痰Xpert MTB/RIF单独检测和联合检测的灵敏度和特异度。用ROC曲线分析胸水ADA检测结果,比较不同临界值时的灵敏度和特异度。结果试验组胸水ADA和痰Xpert MTB/RIF检测水平均高于对照组,差异有统计学意义(P<0.05)。胸水ADA临界值取23 U/L时,灵敏度为81.01%,此时曲线下面积为0.79;胸水ADA临界值取50 U/L时,灵敏度为35.4%,曲线下面积为0.26。差异有统计学意义(P<0.05).联合痰Xpert MTB/RIF和胸水ADA检测,其灵敏度为86.34%,高于痰Xpert MTB/RIF或胸水ADA单独检测的灵敏度。结论胸水ADA取23 U/L的灵敏度高于其临界值取50U/L的灵敏度。联合胸水ADA与痰Xpert MTB/RIF检测对于结核性胸膜炎有较高的诊断价值。
Objective To investigate the diagnostic value of adenosine deaminase(ADA)in hydrothorax combined with mycobacterium sputum/rifampicin resistance real-time fluorescent quantitative nucleic acid amplification(Xpert MTB/RIF)in tuberculous pleurisy and the diagnostic value of ADA in different critical values.Methods Totally 152 patients with pleural effusion admitted to our hospital from April 2019 to December 2019 were selected.According to the CT/disease examination results,they were divided into the tuberculous pleural effusion group(experimental group)and the non-tuberculous pleural effusion group(control group).After admission,chest fluid ADA and sputum Xpert MTB/RIF tests were conducted,and the sensitivity and specificity of chest fluid ADA and sputum Xpert MTB/RIF tests were compared.ROC curve was used to analyze the results of ADA detection of thoracic effusion,and the sensitivity and specificity of different critical values were compared.Results The detection levels of pleural fluid ADA and sputum Xpert MTB/RIF in the experimental group were higher than those in the control group,and the difference was statistically significant(P<0.05).When the critical value of pleural fluid ADA was 23 U/L,the sensitivity was 81.01%,and the area under the curve was 0.79.The sensitivity of combined sputum Xpert MTB/RIF and pleural fluid ADA detection was 86.34%,which was higher than that of sputum Xpert MTB/RIF or pleural fluid ADA detection alone.Conclusion The sensitivity of taking 23 U/L of pleural fluid ADA is higher than that of taking 50 U/L of its critical value.Combined pleural fluid ADA and sputum Xpert MTB/RIF detection has a high diagnostic value for tuberculous pleurisy.
作者
吴春刚
WU Chungang(Yulin Red Cross Hospital of Guangxi,Yulin,Guangxi 537000,China)
出处
《大医生》
2020年第3期21-24,共4页
Doctor
