【摘要】：目的探討多技術(shù)聯(lián)合檢測(cè)用于結(jié)核病及耐多藥結(jié)核病快速診斷的臨床價(jià)值。方法應(yīng)用濃縮涂片法、結(jié)核分枝桿菌DNA熒光定量法(TB-DNA)和結(jié)核分枝桿菌RNA恒溫?cái)U(kuò)增檢測(cè)(SAT TB-RNA)組成的結(jié)核快速診斷技術(shù)(簡(jiǎn)稱快速法)及線性探針結(jié)核分枝桿菌耐藥快速檢測(cè)系統(tǒng)(Hain Geno-Type MTBDRplus,簡(jiǎn)稱HAIN)對(duì)1 180例結(jié)核病患者和1 120例非結(jié)核病對(duì)照者分別進(jìn)行檢測(cè),同步進(jìn)行BACTEC MGIT-960培養(yǎng)、鑒定及藥敏試驗(yàn),比較各方法的敏感性和特異性及結(jié)核病、耐多藥結(jié)核病檢出率。結(jié)果以BACTEC MGIT-960培養(yǎng)鑒定結(jié)果為金標(biāo)準(zhǔn),快速法的敏感度為97.84%(543/555),特異度為96.16%(601/625),符合率為96.95%(1 144/1 180);2種方法的結(jié)核病檢出率比較差異無(wú)統(tǒng)計(jì)學(xué)意義(χ2=0.245,P0.05);以BACTEC MGIT-960藥敏試驗(yàn)為金標(biāo)準(zhǔn),HAIN檢出耐多藥結(jié)核病的敏感度為93.62%(44/47),特異度為99.41%(508/511),符合率為99.46%(552/555);2種方法的耐多藥結(jié)核病檢出率比較差異無(wú)統(tǒng)計(jì)學(xué)意義(χ2=0.102,P0.05)�？焖俜ńY(jié)果報(bào)告時(shí)間縮短為1d,HA1N報(bào)告時(shí)間為2d。結(jié)論多技術(shù)聯(lián)合檢測(cè)對(duì)快速診斷結(jié)核病及耐多藥結(jié)核病的敏感性和特異性都有明顯的優(yōu)勢(shì),顯著縮短了檢測(cè)時(shí)間,具有快速準(zhǔn)確的診斷價(jià)值。
[Abstract]:Objective to evaluate the clinical value of multi-technique combined detection in the rapid diagnosis of tuberculosis and multi-drug resistant tuberculosis. Methods the concentrated smear method was used. Rapid diagnosis of Mycobacterium tuberculosis by DNA fluorescence quantitative assay (TB-DNA) and RNA isothermal amplification assay (SAT TB-RNA) and linear probe rapid detection system for drug resistance of Mycobacterium tuberculosis (Hain Geno-Type MTBDRplus,) HAIN was used to detect 1 180 tuberculosis patients and 1 120 non-tuberculosis controls. BACTEC MGIT-960 culture, identification and drug sensitivity test were carried out simultaneously to compare the sensitivity and specificity of each method and the detection rate of multidrug resistant tuberculosis (MDR-TB). Results the results of BACTEC MGIT-960 culture were used as gold standard. The sensitivity of rapid method was 97.84% (543 / 555), the specificity was 96.16% (601 / 625), the coincidence rate was 96.95% (1 144 / 1 180), there was no significant difference between the two methods (蠂 2 / 0.245 P 0.05), and the sensitivity of HAIN was 93.62% (44 / 47). The detection rate of MDR-TB was 99.41% (508 / 511), and the coincidence rate was 99.46% (552 / 555). There was no significant difference in the detection rate of MDR-TB between the two methods (蠂 2 / 0.102 P 0.05). The result reporting time of fast method was shortened to 1 day and ha 1 N time was 2 days. Conclusion Multi-technique combined detection has obvious advantages in the sensitivity and specificity of rapid diagnosis of tuberculosis and multi-drug resistant tuberculosis. It can significantly shorten the detection time and has rapid and accurate diagnostic value.
【作者單位】： 廣東省汕頭市結(jié)核病防治所;
【基金】：廣東省汕頭市科技重點(diǎn)攻關(guān)課題(No.2013072)
【分類號(hào)】：R52;R440

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