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Diagnostic value of tuberculosis molecular biological detection of bronchoalveolar lavage fluid and peripheral blood T cell spot test in the sputum smear negative pulmonary tuberculosis patients |
ZHANG Yan1 WANG Hua2 HOU Jing1 WANG Qing1 |
1.The Third Department of Tuberculosis, Anhui Chest Hospital, Anhui Province, Hefei 230022, China;
2.the Eighth Department of Tuberculosis, Anhui Chest Hospital, Anhui Province, Hefei 230022, China
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Abstract Objective To explore the diagnostic value of tuberculosis molecular biological detection of bronchoalveolar lavage fluid and peripheral blood T cell spot test in the sputum smear negative pulmonary tuberculosis patients. Methods A total of 198 patients with suspected pulmonary tuberculosis and negative acid-fast bacilli stain on sputum smears admitted to the Anhui Chest Hospital from January 2020 to April 2021 were selected as the study objects. All patients underwent tracheoscopy, local bronchoalveolar lavage fluid samples were taken for tuberculosis (TB)-DNA, TB-RNA, Xpert MTB/RIF detection and peripheral blood T cell spot test, respectively, diagnosis of criteria pulmonary tuberculosis WS 288—2017 was as the gold standard . The consistency of the above four tests with the gold standard was compared, and the consistency of the combination of Xpert MTB/RIF detection in bronchoalveolar lavage fluid and peripheral blood T cell spot test with the gold standard was compared. The diagnostic efficacy of each test was analyzed. Results Among 198 patients, 153 were diagnosed as pulmonary tuberculosis. The four single tests and the combination of Xpert MTB/RIF detectionin bronchoalveolar lavage fluid and peripheral blood T cell spot test all had certain consistency with the gold standard (Kappa=0.512, 0.449, 0.327, 0.373, 0.793, P<0.05). The sensitivity and specificity of the combination of Xpert MTB/RIF detection in bronchoalveolar lavage fluid and peripheral blood T cell spot test were 90.20% and 97.78%, respectively. Conclusion Bronchoalveolar lavage fluid Xpert MTB/RIF detection combined with peripheral blood T cell spot test in the diagnosis of sputum smear negative pulmonary tuberculosis patients is consistent with the gold standard, and the sensitivity and specificity are good, which can be used for clinical auxiliary examination.
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