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临床输血与检验

临床输血与检验 ›› 2019, Vol. 21 ›› Issue (3): 297-301.DOI: 10.3969/j.issn.1671-2587.2019.03.020

• 临床检验 • 上一篇    下一篇

单核细胞与淋巴细胞比值联合SAT-TB法对于涂阴肺结核的鉴别诊断价值

翟荣荣   

  1. 237005 安徽医科大学附属六安市人民医院医学检验科
  • 收稿日期:2018-10-15 出版日期:2019-06-20 发布日期:2019-06-17
  • 作者简介:翟荣荣（1984-）,女,安徽肥西人,主管检验师,硕士,主要从事为免疫及分子生物学检验工作,（E-mail）zhairongrong0324@163.com。

The Value of Monocyte-to-lymphocyte Ratio Combined with Simultaneous Amplification and Testing for TB-RNA （SAT-TB） in Differential Diagnosis of Smear-Negative Pulmonary Tuberculosis

ZHAI Rong-rong   

  1. Clinical Laboratory Center, Lu'an Hospital of Anhui Medical University, Lu'an, Anhui 237005
  • Received:2018-10-15 Online:2019-06-20 Published:2019-06-17

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摘要： 目的 探讨单核/淋巴细胞比值（monocyte-to-lymphocyte ratio, MLR）联合实时荧光恒温扩增检测技术（simultaneous isothermal Amplification and Testing,SAT）对涂阴肺结核的预测及其对非结核性肺部疾患的鉴别诊断价值。方法 选择来本院就诊的120例肺部疾病患者为研究对象,65例涂阴肺结核患者为实验组,55例非结核病患者为对照组,同时进行全血细胞计数和TB RNA检测,采用受试者工作曲线ROC对MLR截断值进行分析,计算两种方法及联合检测对于涂阴肺结核的检出灵敏度、特异度。结果 与非结核病患者相比,涂阴肺结核患者外周血单核细胞数量、MLR值及TB-RNA阳性率均明显升高（P<; 0.001）。受试者工作曲线（ROC）分析显示,MLR预测涂阴肺结核的灵敏度和特异度分别为61.5%、67.3%。与SAT-TB法联合应用的灵敏度、特异性、阴性预测值、阳性预测值分别为76.9%,67.3%,71.2%和73.5%,灵敏度明显高于MLR和SAT-TB法的单独应用,差异有统计学意义（P=0.043;P<; 0.001）。结论 MLR联合SAT-TB法对于涂阴肺结核有较好的预测和鉴别诊断价值,对控制结核病的传播具有一定意义。

关键词: 涂阴肺结核, 恒温扩增, 单核/淋巴细胞比值, 鉴别诊断

Abstract: Objective To investigate the predictive value of monocyte-to-lymphocyte ratio （MLR） combined with TB-RNA in smear-negative tuberculosis for differential diagnosis of pulmonary diseases. Methods One hundred and twenty patients with pulmonary diseases in the hospital were examined for blood cell counts and TB-RNA, among them included 65 smear-negative cases of pulmonary tuberculosis （experimental group） and 55 cases of non-tuberculosis （the control group） . The cut-off value of MLR was analyzed by ROC curve, and the sensitivity and specificity of the two markers and the combined detection for smear-negative pulmonary tuberculosis were calculated. Results Compared with non-tuberculosis patients, the number of peripheral monocytes, MLR and positive rate of TB-RNA in the sputum samples of smear-negative pulmonary tuberculosis patients were significantly increased （P<0.001）. The sensitivity and specificity of MLR in predicting smear-negative pulmonary tuberculosis were 61.5% and 67.3%, respectively. When combined with SAT-TB, the sensitivity, specificity, NPV and PPV were 76.9%, 67.3%, 71.2% and 73.5%, respectively. The combined sensitivity was notably higher than that of MLR and SAT-TB alone （P=0.043; P<0.001）. Conclusion The MLR combined with SAT-TB has a promising predictive and differential diagnostic significance in smear-negative pulmonary tuberculosis, indicating a potential value in controlling the spread of tuberculosis.

Key words: Smear-negative pulmonary tuberculosis, Isothermal amplification, Monocyte-to-lymphocyte ratio, Differential diagnosis

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