Page 183 - 北京京煤集团总医院第十届·2022学术年会论文集

北京京煤集团总医院 第十届·2022 学术年会论文集

tuberculosis in Beijing Beijing Coal Group General Hospital from January 2017 to June 2021 were

collected continuously. At the same time, Xpert test, CPA and Bactec MGIT 960 were used for

detection. Based on clinical comprehensive diagnosis, the efficacy of three detection methods and
three combined detection methods in detecting coal worker's pneumoconiosis complicated with

smear negative tuberculosis was evaluated (generally divided into “tuberculosis patients”and “non-
tuberculosis patients”). Results Based on clinical comprehensive diagnosis, the sensitivity of

MGIT 960 culture, CPA and Xpert to MTB was 10.9% (13/119), 29.4% (35/119) and 47.9%

(57/119), respectively. The area under ROC curve (0.565, 0.628 and 0.714) of MGIT 960 culture,

CPA method and Xpert for detecting coal workers' pneumoconiosis complicated with smear

negative tuberculosis were respectively. It is suggested that Xpert test is consistent with clinical

diagnosis results. The sensitivity of MGIT 960 culture combined with CPA and Xpert test and the

combined test of the three methods (MGIT 960 culture, Xpert test and CPA) were as follows:

35.3%(42/119), 47.9(57/119), 55.5%(66/119), respectively. The specificity was 96.2%. The results

were consistent with clinical diagnosis (Kappa=0.272, Kappa=0.392, Kappa=0.467). The AUC

values of the three combined detection methods were 0.658, 0.710 and 0.765, respectively. It is

suggested that the combined detection of the three methods is consistent with the clinical diagnosis

results. Conclusion Among patients with coal workers' pneumoconiosis complicated with smear

negative tuberculosis, The sensitivity of Xpert test is the highest. The combined detection of the
three methods can significantly improve the diagnostic sensitivity and the coincidence rate with

clinical diagnosis.

Key words：pneumoconiosis；tuberculosis，pulmonary；Laboratory techniques and procedures;

Diagnostic self evaluation; Evaluation studies

肺结核是尘（矽）肺常见的并发症，合并肺结核是该类患者的直接死亡原因之一 [1-3] 。煤

工尘肺合并肺结核较多，发生率约为 22%。目前尘（矽）肺合并肺结核的主要诊断依据是胸

部 X 线摄片（简称 “胸片”）和痰液结核分枝杆菌(Mycobacterium tuberculosis，MTB)的检查。

但由于矽肺患者胸部 X 线摄片检查结果的多变性和不确定性，使痰液 MTB 检查结果成为矽

[2]
肺患者 MTB 感染和结核病复发确诊的直接病原学证据 。菌阴肺结核占全部肺结核的
[4]
40%～60%。涂阴肺结核患病率占肺结核患病率的 85.62% ，结核病的早期诊断及其耐药性
的检测，对于很好地控制耐药结核病的传播具有十分重要的意义 。
[5]

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