RNA恒温扩增实时荧光检测技术在检测脑脊液中结核分枝杆菌的应用

发布时间：2018-03-30 22:22

本文选题：脑脊液　切入点：结核分枝杆菌　出处：《广东医学》2017年11期

【摘要】：目的评估用RNA恒温扩增实时荧光检测技术(SAT-TB)快速检测脑脊液中结核分枝杆菌(MTB)的临床应用价值。方法采集来我院接受检查的高度疑似儿童结核性脑膜炎患儿96例(A组),非结核性脑膜炎儿童78例(B组),分别采用夹层杯离心集菌法、罗氏培养法、SAT-TB和MTB DNA荧光定量扩增法(TB DNA)同时检测,比较筛检指标及临床应用价值。结果 A组脑脊液检测中罗氏培养法、TB DNA和SAT-TB法检测阳性率分别为40.63%、39.58%、42.71%,三者差异无统计学意义(X~2=0.20,P0.05);以罗氏培养法作为金标准,SAT-TB法的灵敏度、特异度、阳性预测值、阴性预测值、正确指数、误诊率、漏诊率、诊断符合率分别为92.31%、91.23%、87.80%、94.55%、0.84%、8.77%、7.69%和91.67%;TB DNA法的各项指标分别为66.67%、78.95%、68.42%、77.59%、0.46%、21.05%、33.33%和73.96%。结论 SAT-TB检测脑脊液标本中的MTB,具有快速、敏感度和特异度较高等优点,可提高脑脊液标本中MTB的检出率,从而提高儿童结核性脑膜炎的诊断水平。
[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.
【作者单位】：徐州市传染病医院结核科;
【基金】：徐州市2014年推动科技创新后补助备案项目(编号:KC14SH055)
【分类号】：R446.14;R529.3

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