关键词: 结核分枝杆菌, 肺泡灌洗液, 结核和利福平耐药基因实时荧光定量核酸扩增, BD-960快速培养, 罗氏培养, 菌阴肺结核

Abstract:

Objective To investigate the diagnostic value of Xpert Mycobacterium tuberculosis/rifampicin（Xpert MTB/RIF） combined with BD-960 rapid culture and Roche culture in bronchoalveolar lavage fluid（BALF） for bacteriological negative pulmonary tuberculosis（BGT）. Methods A total of 210 patients with suspected BGT treated at former Jingzhou Chest Hospital were enrolled between January 2019 and August 2022，and BALF Xpert MTB/RIF，BD-960 rapid culture and Roche culture were performed. According to clinical medical history and clinical diagnosis results（imaging，bronchoscopy），there were 136 cases with BGT and 74 cases without BGT. Taking clinical diagnosis as the golden standard，the efficiency of BALF Xpert MTB/RIF combined with BD-960 rapid culture and Roche culture in the diagnosis of BGT was evaluated. Results Among the 210 patients with suspected BGT，clinical diagnosis showed that there were 136 cases with BGT and 74 cases without BGT. Taking clinical diagnosis as the golden standard，the sensitivities，specificities，accuracies，positive predictive values，negative predictive values and Kappa values of Roche culture， BD-960 rapid culture and BALF Xpert MTB/RIF and combined determination in the diagnosis of BGT were 56.62%， 91.89%， 69.05%， 92.77%， 53.54%， 0.417；58.82%， 87.84%， 69.05%， 89.89%， 53.72%， 0.426；67.64%， 94.59%， 77.14%， 95.83%， 61.40%， 0.554 and 76.47%， 97.30%， 83.81%， 98.11%， 69.23%， 0.675， respectively. Conclusions The combined determination of BALF Xpert MTB/RIF， BD-960 rapid culture and Roche culture has high diagnostic value for BGT，which can improve diagnostic accuracy rate of BGT.

Key words: Mycobacterium tuberculosis, Bronchoalveolar lavage fluid, Xpert Mycobacterium tuberculosis/rifampicin, BD-960 rapid culture, Roche culture, Bacteriological negative pulmonary tuberculosis