Department of Infection Disease, Wenzhou Central Hospital, The Dingli Clinical Institute of Wenzhou Medical University, Wenzhou, China.
Front Public Health. 2022 Jun 16;10:830477. doi: 10.3389/fpubh.2022.830477. eCollection 2022.
This study aimed to determine the value of the simultaneous amplification and testing for in bronchoalveolar lavage fluid (BALF) in the diagnosis of smear-negative pulmonary tuberculosis (PTB).
A total of 316 patients were selected, of which 197 had smear-negative PTB (observation group), and 119 did not have TB (control group). Bronchoscopy was performed in both groups, and BALF samples were collected for acid-fast bacilli smears, simultaneous amplification/testing for TB (SAT-TB), and BACTEC MGIT 960 cultures. The sensitivity, specificity, positive predictive, and negative predictive values of SAT-TB in BALF for the diagnosis of negative TB were calculated.
The sensitivity of SAT-TB detection was 45.18%, which was significantly higher than smears and slightly lower than cultures. The specificity of SAT-TB was 99.16%, which differed slightly from the other two methods. The positive predictive value was 98.89%, which was not significantly different from the other two methods. The negative predictive value of SAT-TB was 58.91%, which was higher than smears and slightly lower than cultures.
The very high specificity and negative prediction of SAT-TB in BALF means that the method has great application value for the rapid diagnosis of smear-negative PTB.
本研究旨在探讨支气管肺泡灌洗液（BALF）中同步扩增检测（SAT-TB）在诊断菌阴肺结核（PTB）中的价值。
选取 316 例患者，其中 197 例菌阴肺结核患者（观察组），119 例非结核患者（对照组）。两组均行支气管镜检查，采集 BALF 标本进行抗酸杆菌涂片、SAT-TB 和 BACTEC MGIT 960 培养。计算 SAT-TB 对菌阴肺结核的诊断价值，包括灵敏度、特异度、阳性预测值和阴性预测值。
SAT-TB 检测的灵敏度为 45.18%，明显高于涂片法，略低于培养法。SAT-TB 的特异度为 99.16%，与其他两种方法略有差异。阳性预测值为 98.89%，与其他两种方法无显著差异。阴性预测值为 58.91%，高于涂片法，略低于培养法。
BALF 中 SAT-TB 具有极高的特异性和阴性预测值，对菌阴肺结核的快速诊断具有重要的应用价值。
