联合检测技术用于结核病及耐多药结核病快速诊断的研究

发布时间：2018-09-11 18:08

【摘要】：目的探讨多技术联合检测用于结核病及耐多药结核病快速诊断的临床价值。方法应用浓缩涂片法、结核分枝杆菌DNA荧光定量法(TB-DNA)和结核分枝杆菌RNA恒温扩增检测(SAT TB-RNA)组成的结核快速诊断技术(简称快速法)及线性探针结核分枝杆菌耐药快速检测系统(Hain Geno-Type MTBDRplus,简称HAIN)对1 180例结核病患者和1 120例非结核病对照者分别进行检测,同步进行BACTEC MGIT-960培养、鉴定及药敏试验,比较各方法的敏感性和特异性及结核病、耐多药结核病检出率。结果以BACTEC MGIT-960培养鉴定结果为金标准,快速法的敏感度为97.84%(543/555),特异度为96.16%(601/625),符合率为96.95%(1 144/1 180);2种方法的结核病检出率比较差异无统计学意义(χ2=0.245,P0.05);以BACTEC MGIT-960药敏试验为金标准,HAIN检出耐多药结核病的敏感度为93.62%(44/47),特异度为99.41%(508/511),符合率为99.46%(552/555);2种方法的耐多药结核病检出率比较差异无统计学意义(χ2=0.102,P0.05)。快速法结果报告时间缩短为1d,HA1N报告时间为2d。结论多技术联合检测对快速诊断结核病及耐多药结核病的敏感性和特异性都有明显的优势,显著缩短了检测时间,具有快速准确的诊断价值。
[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.
【作者单位】：广东省汕头市结核病防治所;
【基金】：广东省汕头市科技重点攻关课题(No.2013072)
【分类号】：R52;R440

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