Touré N O, Wayzani M, Thiam K, Cissé M F, Mbaye F B
Service de pneumologie, Centre hospitalier national universitaire de Fann, 60, rue Abdou Karim Bourgie, 1657 Dakar, Sénégal.
Service de pneumologie, Centre hospitalier national universitaire de Fann, 60, rue Abdou Karim Bourgie, 1657 Dakar, Sénégal.
Rev Mal Respir. 2017 Sep;34(7):758-764. doi: 10.1016/j.rmr.2017.01.003. Epub 2017 Feb 15.
Performance of the Xpert MTB/RIF for the detection of Mycobacterium tuberculosis in pleural liquid is poorly described. The aim of this study was to determine its usefulness for the etiological diagnosis of a tuberculous pleurisy.
We performed a descriptive cross-sectional study, with analytical design, including all the patients having a unilateral serofibrinous pleurisy, exudative, lymphocytic, and sterile. The diagnosis of pleural tuberculosis was considered based on epidemiological, clinical, paraclinical and therapeutic arguments. The Xpert MTB/RIF of the pleural fluid was carried out among all patients.
Pleural tuberculosis was confirmed in 301 patients. The median age was 32years. Our study has included 217 men (72.1%) with a final sex ratio of 2.6. The cost of the pleural biopsy coupled with histology made it practicable in only 90 patients (29.9%) with a yield of 80%. The Xpert MTB/RIF of the pleural liquid was positive in only 10 patients (3.3% of the cases).
Gene amplification by Xpert MTB/RIF of the pleural liquid is much less effective in establishing the diagnosis of tuberculous pleurisy than pleural biopsy, which remains the gold standard.
关于Xpert MTB/RIF检测胸腔积液中结核分枝杆菌的性能描述较少。本研究的目的是确定其在结核性胸膜炎病因诊断中的实用性。
我们进行了一项描述性横断面研究，采用分析性设计，纳入所有患有单侧浆液纤维蛋白性胸膜炎、渗出性、淋巴细胞性且无菌的患者。基于流行病学、临床、辅助检查和治疗方面的依据来考虑胸膜结核的诊断。对所有患者进行胸腔积液的Xpert MTB/RIF检测。
301例患者确诊为胸膜结核。中位年龄为32岁。我们的研究纳入了217名男性（72.1%），最终性别比为2.6。胸腔活检联合组织学检查的费用使得仅90例患者（29.9%）能够进行该项检查，阳性率为80%。胸腔积液的Xpert MTB/RIF检测仅10例患者呈阳性（占病例的3.3%）。
与胸腔活检相比，通过Xpert MTB/RIF对胸腔积液进行基因扩增在确立结核性胸膜炎诊断方面效果要差得多，胸腔活检仍是金标准。
