34. Vai trò của xét nghiệm GeneXpert MTB/RIF dịch phế quản trong chẩn đoán lao phổi tại Bệnh viện Đại học Y Hà Nội

Abstract

In recent years, GeneXpert MTB/RIF is one of the priority molecular biology techniques recommended by the World Health Organization (WHO) for the diagnosis of tuberculosis due to its superiority in early diagnosis and treatment applications. Our study was conducted to review the results of GeneXpert MTB/RIF bronchial fluid test in the diagnosis of pulmonary tuberculosis, especially in subjects with negative sputum AFB and Xpert gene. A descriptive cross-sectional study was performed on 388 patients undergoing bronchoscopy at the Department of Endocrinology and Respiratory Medicine, Hanoi Medical University, from January 2022 to December 2022. All patients had clinical symptoms or imaging findings suggesting tuberculosis with negative sputum TB tests including AFB test and sputum GeneXpert MTB/RIF. Men and women accounted for equal proportions in the study. The mean age of patients in the study was 57.2 ± 16.1 years old. Tests for direct AFB in bronchial fluid were positive in 4.4% of all patients. GeneXpert MTB/RIF test positive in bronchial fluid accounted for 14.9% of all study patients and accounted for 11.1% in group with negative bronchial AFB test. The lesion morphology on bronchoscopy of patients with a positive GeneXpert MTB/RIF bronchial fluid test included: black pigmented plaques in the bronchial lumen, accounted for 22.4%; bronchial mucosal congestion accounted for 29.3%; bronchial turbid mucus represented 37.9% and 62.1% of patients had normal bronchoscopy picture.