發(fā)布時間：2018-03-30 22:22

  本文選題：腦脊液　切入點：結(jié)核分枝桿菌　出處：《廣東醫(yī)學(xué)》2017年11期

【摘要】：目的評估用RNA恒溫擴增實時熒光檢測技術(shù)(SAT-TB)快速檢測腦脊液中結(jié)核分枝桿菌(MTB)的臨床應(yīng)用價值。方法采集來我院接受檢查的高度疑似兒童結(jié)核性腦膜炎患兒96例(A組),非結(jié)核性腦膜炎兒童78例(B組),分別采用夾層杯離心集菌法、羅氏培養(yǎng)法、SAT-TB和MTB DNA熒光定量擴增法(TB DNA)同時檢測,比較篩檢指標及臨床應(yīng)用價值。結(jié)果 A組腦脊液檢測中羅氏培養(yǎng)法、TB DNA和SAT-TB法檢測陽性率分別為40.63%、39.58%、42.71%,三者差異無統(tǒng)計學(xué)意義(X~2=0.20,P0.05);以羅氏培養(yǎng)法作為金標準,SAT-TB法的靈敏度、特異度、陽性預(yù)測值、陰性預(yù)測值、正確指數(shù)、誤診率、漏診率、診斷符合率分別為92.31%、91.23%、87.80%、94.55%、0.84%、8.77%、7.69%和91.67%;TB DNA法的各項指標分別為66.67%、78.95%、68.42%、77.59%、0.46%、21.05%、33.33%和73.96%。結(jié)論 SAT-TB檢測腦脊液標本中的MTB,具有快速、敏感度和特異度較高等優(yōu)點,可提高腦脊液標本中MTB的檢出率,從而提高兒童結(jié)核性腦膜炎的診斷水平。
[Abstract]:Objective to evaluate the clinical value of rapid detection of Mycobacterium tuberculosis in cerebrospinal fluid (CSF) by RNA constant temperature amplification real-time fluorescence technique (SAT-TB). Methods 96 children with highly suspected tuberculous meningitis were examined in our hospital. Group A (n = 78) and group B (n = 78) with non-tuberculous meningitis were treated with dissecting cup centrifugation. The detection of SAT-TB and MTB DNA were performed simultaneously by Roche culture method. Results the positive rates of DNA and SAT-TB in cerebrospinal fluid examination in group A were 40.6339.58 and 42.71, respectively. There was no significant difference among the three groups, and the sensitivity and specificity of Roche culture as gold standard SAT-TB method were not statistically significant. The positive predictive value, the negative predictive value, the correct index, the misdiagnosis rate, the missed diagnosis rate and the diagnostic coincidence rate were 92.31K 91.23 and 87.800.554.5547.69% and 91.6767 TB DNA, respectively. The indexes of DNA were 66.67, 78.9568.42n 77.590.460.460.460.1.055.33.33% and 73.966.Conclusion the detection of MTBs in cerebrospinal fluid samples by SAT-TB is rapid. The high sensitivity and specificity can improve the detection rate of MTB in cerebrospinal fluid (CSF) samples and improve the diagnostic level of tuberculous meningitis in children.
【作者單位】： 徐州市傳染病醫(yī)院結(jié)核科;
【基金】：徐州市2014年推動科技創(chuàng)新后補助備案項目(編號:KC14SH055)
【分類號】：R446.14;R529.3

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