[1]盛 杰,朱 洋,地里下提·阿不力孜,等.超声、CT引导下经皮穿刺联合Xpert MTB/RIF技术早期诊断脊柱结核的应用研究[J].医学信息,2020,33(08):64-66.[doi:10.3969/j.issn.1006-1959.2020.08.021]
　SHENG Jie,ZHU Yang,Di Xia Di Abulizi,et al.Ultrasound and CT Guided Percutaneous Puncture Combined with Xpert MTB/RIF Technology for Early Diagnosis of Spinal Tuberculosis[J].Medical Information,2020,33(08):64-66.[doi:10.3969/j.issn.1006-1959.2020.08.021]
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超声、CT引导下经皮穿刺联合Xpert MTB/RIF技术早期诊断脊柱结核的应用研究()
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医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
33卷
期数:
2020年08期
页码:
64-66
栏目:
论著
出版日期:
2020-04-15

文章信息/Info

Title:
Ultrasound and CT Guided Percutaneous Puncture Combined with Xpert MTB/RIF Technology for Early Diagnosis of Spinal Tuberculosis
文章编号:
1006-1959（2020）08-0064-03
作者:
盛 杰; 朱 洋; 地里下提·阿不力孜; 等
（1.新疆医科大学第一附属医院骨科，新疆 乌鲁木齐 830011；2.新疆维吾尔自治区胸科医院骨科，新疆 乌鲁木齐 830011；3.新疆医科大学第五附属医院医保办，新疆 乌鲁木齐 830011）
Author(s):
SHENG Jie; ZHU Yang; Di Xia Di Abulizi; et al
(1.Department of Orthopedics,the First Affiliated Hospital of Xinjiang Medical University,Urumqi 830011,Xinjiang,China;2.Department of Orthopedics,Chest Hospital of Xinjiang Uygur Autonomous Region,Urumqi 830011,Xinjiang,China;3.Medical Insurance Office of the Fifth Affiliated Hospital of Xinjiang Medical University,Urumqi 830011,Xinjiang,China)
关键词:
脊柱结核; 穿刺术; 核酸扩增技术; 超声; 结核菌培养; 抗酸染色
Keywords:
Spinal tuberculosis; Puncture; Nucleic acid amplification technique; Ultrasound; Tuberculosis culture; Acid-fast staining
分类号:
R529.2
DOI:
10.3969/j.issn.1006-1959.2020.08.021
文献标志码:
A
摘要:
目的 探讨超声、CT引导下经皮穿刺微创技术联合Xpert MTB/RIF技术早期诊断脊柱结核的临床应用价值。方法 选取2018年1月~2019年12月在新疆维吾尔自治区胸科医院骨科接受超声、CT引导下经皮穿刺的疑似脊柱结核患者67例，穿刺获取的病灶标本同时采用Xpert MTB/RIF、BACTEC MGIT 960和抗酸染色技术进行结果对比。以临床综合诊断为参照标准，评价Xpert MTB/RIF技术对脊柱结核的诊断效能。结果 以临床综合诊断为参照标准，67例疑似患者中确诊为脊柱结核患者43例，非脊柱结核24例。三种检测方法报告时间比较：抗酸染色为（3.67±1.72）h，Xpert技术为（1.00±0.40）d，BACTEC MGIT 960法结核菌培养为（10.40±2.90）d。抗酸染色、结核菌培养及Xpert技术诊断脊柱结核的敏感度和特异度分别为34.88%和100.00%，48.84%和95.83%，81.40%和95.83%；一致性分析显示：Xpert技术一致性较好（Kappa=0.73），抗酸染色（Kappa=0.28）和结核菌培养（Kappa=0.37）一致性一般。三种检测方法对脊柱结核的诊断价值为Xpert技术（AUC值=0.89）＞结核菌培养（AUC值=0.72）＞抗酸染色（AUC值=0.67）。结论 经超声、CT引导下的经皮穿刺术具有早期、微创、安全的优势，联合Xpert技术对脊柱结核的早期准确诊断具有较高的价值。
Abstract:
Objective To explore the clinical application value of ultrasound and CT guided percutaneous puncture minimally invasive technique combined with Xpert MTB/RIF technique for early diagnosis of spinal tuberculosis.Methods 67 patients with suspected spinal tuberculosis underwent ultrasound and CT guided percutaneous puncture in the Department of Orthopedics, Chest Hospital of Xinjiang Uygur Autonomous Region from January 2018 to December 2019,the specimens obtained by puncture were compared with Xpert MTB/RIF, BACTEC MGIT 960 and acid-fast staining technique. Using the comprehensive clinical diagnosis as the reference standard, the diagnostic efficacy of Xpert MTB/RIF technology for spinal tuberculosis was evaluated.Results Taking the comprehensive clinical diagnosis as the reference standard, of the 67 suspected patients, 43 were diagnosed with spinal tuberculosis and 24 were non-spine tuberculosis. Comparison of the reporting time of the three detection methods: acid-fast staining is (3.67±1.72) h, Xpert technique is (1.00±0.40) d, BACTEC MGIT 960 method tuberculosis culture is (10.40±2.90) d The sensitivity and specificity of acid-fast staining, tuberculosis culture and Xpert technology for the diagnosis of spinal tuberculosis were 34.88% and 100.00%, 48.84% and 95.83%, 81.40% and 95.83%, respectively.Consistency analysis showed that Xpert technology had good consistency(Kappa=0.73),acid-fast staining(Kappa=0.28) and tuberculosis culture (Kappa=0.37) were generally consistent. The diagnostic value of the three detection methods for spinal tuberculosis is Xpert technique(AUC value=0.89)> tuberculosis culture (AUC value=0.72)> acid-fast staining (AUC value=0.67).Conclusion Ultrasound and CT-guided percutaneous puncture has the advantages of early, minimally invasive and safe. Combined with Xpert technology, it has high value for the early and accurate diagnosis of spinal tuberculosis.

参考文献/References:

[1]李元,秦世炳.脊柱结核手术后的复发因素分析及处理[J].中国防痨杂志,2019,41(4):369-370. [2]World Health Organization.Xpert MTB/RIF system for the diagnosis of pulmonary and extra-pulmonary TB in adults and children.Policy update[M].Geneva:World Health Organization,2013．[3]徐敏,熊绪,张钰,等.非特异性脊柱感染误诊为脊柱结核八例分析[J].临床误诊误治,2016,29(4):46-48.[4]马远征.当前脊柱结核诊疗的现状与相关问题[J].结核病与肺部健康杂志,2017,6(3):201-203.[5]Meldau R,Peter J,Theron G,et al.Comparison of same day diagnostic tools including Gene Xpert and unstimulated IFN-γ for the evaluation of pleural tuberculosis:a prospective cohort study[J].Bmc Pulmon Med,2014,14(1):58.[6]董伟杰,秦世炳,兰汀隆,等.Xpert MTB/RIF技术在骨关节结核临床诊断中的应用研究[J].中国防痨杂志,2017,39(4):337-341.[7]Gu Y,Wang G,Dong W,et al.Xpert MTB/RIF and Geno Type MTBDRplus assays for the rapid diagnosis of bone and joint tuberculosis[J].Int J Infect Dis,2015(36):27-30.[8]Arockiaraj J,Michael JS,Amritanand R,et al.The role of Xpert MTB/RIF assay in the diagnosis of tubercular spondylodiscitis[J].Eur Spine J,2017,26(12):3162-3169.

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更新日期/Last Update: 2020-04-15