本文關(guān)鍵詞： 肺結(jié)核 支氣管鏡 T-SPOT 診斷效能　出處：《實用醫(yī)學(xué)雜志》2017年10期 　論文類型：期刊論文

【摘要】：目的:探討支氣管鏡聯(lián)合T-SPOT對肺結(jié)核的診斷效能。方法:納入2015年2月至2016年4月我科住院的高度疑似肺結(jié)核病例248例,據(jù)痰標本來源途徑不同分為對照組、霧化組、支氣管鏡組,據(jù)檢查方式的不同分為支氣管鏡組、T-SPOT組、支氣管鏡+T-SPOT組,行各組痰抗酸涂片陽性率、肺結(jié)核診斷率及診斷效能的比較及支氣管鏡安全性的評估。結(jié)果:支氣管鏡組痰抗酸涂片陽性率最高(37.173%),3組間有統(tǒng)計學(xué)差異(P=0.001);支氣管鏡+T-SPOT組肺結(jié)核診斷率最高(92.670%),3組間有統(tǒng)計學(xué)差異(P=0.000);支氣管鏡+T-SPOT組診斷肺結(jié)核的特異度、靈敏度、陽性預(yù)測值、陰性預(yù)測值、陽性似然比及約登指數(shù)最高,陰性似然比最低;支氣管鏡組并發(fā)癥有3例出血,1例氣胸,1例心律失常。結(jié)論:支氣管鏡聯(lián)合T-SPOT可提升肺結(jié)核的診斷效能,安全可靠。
[Abstract]:Objective: to investigate the diagnostic efficacy of bronchoscopy combined with T-spot in the diagnosis of pulmonary tuberculosis. Methods: from February 2015 to April 2016, 248 highly suspected pulmonary tuberculosis cases were included in our department. According to the origin of sputum samples were divided into control group atomization group bronchoscopy group according to different examination methods divided into bronchoscopy group T-spot group bronchoscopy T-spot group. The positive rate of sputum acid-resistant smear, the diagnosis rate and diagnostic efficacy of pulmonary tuberculosis and the safety evaluation of bronchoscopy were compared. Results: the highest positive rate of sputum acid-resistant smear was 37.173% in bronchoscopy group. There was statistical difference among the three groups. The diagnosis rate of pulmonary tuberculosis in T-spot group was the highest (92.670%). The specificity, sensitivity, positive predictive value, negative predictive value, positive likelihood ratio and Jordan index were the highest and the negative likelihood ratio was the lowest in the T-spot group. The complications of bronchoscope group included 3 cases of hemorrhage and 1 case of pneumothorax arrhythmia. Conclusion: bronchoscopy combined with T-spot can improve the diagnostic efficiency of pulmonary tuberculosis and is safe and reliable.
【作者單位】： 第四軍醫(yī)大學(xué)唐都醫(yī)院呼吸與危重癥醫(yī)學(xué)科;
【基金】：國家公益性行業(yè)科研專項(編號:201402024)
【分類號】：R521
【正文快照】： 【英文13期未換】我國是全世界肺結(jié)核高發(fā)病率國家[1],由于人類免疫缺陷、耐藥菌株、貧困人口流動的增加等影響其發(fā)病率仍在增加,但很多肺結(jié)核患者因無咳痰、痰液質(zhì)量或檢測能力等因素,存在大量痰抗酸桿菌涂片陰性的患者。有報道臨床上結(jié)核分枝桿菌檢測陽性率僅15%~20%,肺外及

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