重庆市高疫情地区病原学阴性肺结核的诊断质量现状OA

Objective To analyze the status quo of diagnostic quality of pulmonary tuberculosis(PTB)with etiological negative in some high epidemic areas in Chongqing City to provide the scientific evidence for optimizing related diagnostic strategies.Methods The patients with pathogenic negative PTB who were regis-tered and treated in the designated medical institutions in six districts and counties in the southeastern and northeastern areas of Chongqing where the epidemic situation was relatively severe in 2023 were selected as the research subjects.The case data of the patients were collected.The municipal expert group conducted the on-site review and evaluated the quality of the original diagnosis.Results Among 463 cases of etiological neg-ative,2.3%of the cases did not undergo the sputum smear examination,while the patients undergoing the sputum culture and molecular biological test accounted for 60.0%and 88.1%respectively.60.5%of the pa-tients conducted the anti-tuberculosis antibody test,and the patients conducting the tuberculin skin tests(26.6%)and interferon-γ release assay(35.6%)did not excess 40.0%.All patients conducted the chest X-ray and DR examination,and 226 cases simultaneously conducted the CT examination.Among them,the chest imageologic results in 368 patients were basically accordant with the primary interpretation in the local fixed-point hospitals.Sixteen patients conducted the normative anti-infection treatment.Forty-four patients execu-ted the discussion of the diagnosis group according to the norms before diagnosis.The overall diagnostic coin-cidence rate was 90.1%(417/463),the over-diagnosis rate was 6.7%(31/463),and the missed diagnosis rate was 3.2%(15/463).Conclusion The PTB diagnostic coincidence rate of etiological negative PTB patients in the high epidemic areas in Chongqing City was 90.1%.The related TB designated medical institutions need to increase the capabilities of identifying active PTB and other lung diseases.