Xpert MTB/RIF与博奥生物RT-PCR检测法对结核性心包炎诊断准确性的比较
Comparison of the Diagnostic Accuracy of Xpert MTB/RIF and CapitalBio RT-PCR Detection Assay for Tuberculous Pericarditis.
作者信息
Yu Guocan, Wang Linhua, Shen Yanqin, Fang Likui, Yang Jun, Ye Bo, Xu Kan, Zhong Fangming
机构信息
Zhejiang Tuberculosis Diagnosis and Treatment Center, Affiliated Hangzhou Chest Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, People's Republic of China.
Department of Hospital Infection, Affiliated Hangzhou Chest Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, People's Republic of China.
出版信息
Infect Drug Resist. 2022 Apr 22;15:2127-2135. doi: 10.2147/IDR.S360064. eCollection 2022.
PURPOSE
We evaluated CapitalBio RT-PCR assay diagnosing tuberculous pericarditis (TBP), performed a head-to-head comparison with Xpert MTB/RIF, and assessed the impact of a parallel test (positive result for either of these two tests).
METHODS
We reviewed suspected TBP patients with Xpert MTB/RIF, CapitalBio RT-PCR assay, and (MTB) culture. We analyzed sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and area under the curve (AUC).
RESULTS
Seventy-four patients were included. Overall sensitivity, specificity, PPV, NPV, and AUC of CapitalBio RT-PCR assay compared with culture were 50%, 91.1%, 64.3%, 85%, and 0.71, respectively. Overall sensitivity, specificity, PPV, NPV, and AUC of Xpert MTB/RIF for TBP were 61.1%, 91.1%, 68.8%, 87.9%, and 0.76. Parallel test values were 72.2%, 91.1%, 72.2%, 91.1%, and 0.82. The diagnostic accuracy of Xpert MTB/RIF was higher than CapitalBio RT-PCR assay but was not significant ( > 0.05). The parallel test could improve diagnostic accuracy, but it was not significant compared to single tests ( > 0.05).
CONCLUSION
CapitalBio RT-PCR assay had a moderate diagnostic accuracy, similar to Xpert MTB/RIF. The parallel test maximized diagnostic efficacy, but differences were not significant. CapitalBio RT-PCR assay and Xpert MTB/RIF for TBP could be an initial option for early diagnosis.
目的
我们评估了博奥生物逆转录聚合酶链反应（RT-PCR）检测法对结核性心包炎（TBP）的诊断效果，与Xpert MTB/RIF进行了直接比较，并评估了联合检测（这两种检测中任意一种呈阳性结果）的影响。
方法
我们回顾性分析了疑似TBP患者的Xpert MTB/RIF检测、博奥生物RT-PCR检测法以及（结核分枝杆菌）培养结果。我们分析了敏感性、特异性、阳性预测值（PPV）、阴性预测值（NPV）和曲线下面积（AUC）。
结果
共纳入74例患者。与培养结果相比，博奥生物RT-PCR检测法的总体敏感性、特异性、PPV、NPV和AUC分别为50%、91.1%、64.3%、85%和0.71。Xpert MTB/RIF对TBP的总体敏感性、特异性、PPV、NPV和AUC分别为61.1%、91.1%、68.8%、87.9%和0.76。联合检测的值分别为72.2%、91.1%、72.2%、91.1%和0.82。Xpert MTB/RIF的诊断准确性高于博奥生物RT-PCR检测法，但差异无统计学意义（P>0.05）。联合检测可提高诊断准确性，但与单项检测相比差异无统计学意义（P>0.05）。
结论
博奥生物RT-PCR检测法具有中等诊断准确性，与Xpert MTB/RIF相似。联合检测可使诊断效能最大化，但差异不显著。博奥生物RT-PCR检测法和Xpert MTB/RIF用于TBP诊断可作为早期诊断的初始选择。
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