聚合酶链反应诊断肺结核：HIV 阳性和阴性个体的比较研究。
Diagnosis of the pulmonary tuberculosis by polymerase chain reaction: a comparative study between HIV-positive and -negative individuals.
机构信息
Programa de Mestrado em Ciências da Saúde, Universidade do Sul de Santa Catarina , Tubarão, SC , Brasil.
出版信息
Braz J Microbiol. 2012 Jan;43(1):261-5. doi: 10.1590/S1517-838220120001000030. Epub 2012 Jun 1.
This study was performed to assess the efficiency of polymerase chain reaction (PCR) directly from sputum for the diagnosis of pulmonary tuberculosis by comparison between HIV-positive and HIV-negative individuals. Sputum samples were collected from hospitalized patients admitted with a clinical diagnosis of pulmonary tuberculosis, and subjected to smear microscopy, culture on LJ medium and detection of M. tuberculosis by PCR. Sensitivity, specificity, and predictive values (positive and negative) were calculated using smear and/or culture at day 42 as the gold standard, by comparing the yield in HIV-positive and HIV-negative individuals. Regardless of serostatus, the technique's yield had 62% sensitivity, 70% specificity, 79% positive predictive value, 50% negative predictive value, and 65% accuracy. HIV-negative had 64% sensitivity, 74% specificity, 75% positive predictive value, 63% negative predictive value, and 68% accuracy. HIV-positive had 59% sensitivity, 33% specificity, 87% positive predictive value, 10% negative predictive value, and 56% accuracy. The PCR showed a higher yield in HIV-negative individuals compared to HIV-positive individuals.
本研究旨在通过比较 HIV 阳性和 HIV 阴性个体，评估聚合酶链反应（PCR）直接从痰液中诊断肺结核的效率。收集住院患者的痰液样本，这些患者临床诊断为肺结核，并进行涂片镜检、LJ 培养基培养和 PCR 检测结核分枝杆菌。使用第 42 天的涂片和/或培养作为金标准，计算敏感性、特异性和预测值（阳性和阴性），比较 HIV 阳性和 HIV 阴性个体的检测结果。无论血清学状态如何，该技术的检测结果均具有 62%的敏感性、70%的特异性、79%的阳性预测值、50%的阴性预测值和 65%的准确性。HIV 阴性个体的敏感性为 64%、特异性为 74%、阳性预测值为 75%、阴性预测值为 63%、准确性为 68%。HIV 阳性个体的敏感性为 59%、特异性为 33%、阳性预测值为 87%、阴性预测值为 10%、准确性为 56%。与 HIV 阳性个体相比，PCR 在 HIV 阴性个体中的检测结果更高。
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