利用噬菌体生物扩增法快速检测痰标本中结核分支杆菌

Study of the rapidly detecting of mycobacterium tuberculosis in sputum with phage amplified biologically assay

目的探讨噬菌体生物扩增(PhaB)法在快速检测痰标本结核分支杆菌(MTB)中的临床应用价值。方法应用PhaB法检测103例痰标本MTB,并与改良罗氏培养法检测结果进行比较。结果103例痰标本PhaB法与培养法检测MTB均阳性67例,均阴性25例,两法不相符11例。如以培养法结果为判断标准,则PhaB法检测痰标本MTB的敏感性、特异性、阳性预测值(PPV)、阳性预测值(NPV)及准确性分别为94.9%(67/71)、73.5%(25/34)、90.5%(67/74)、86.2%(25/29)、89.3%(92/103)。PhaB法对涂阳标本检出率为88.6/%(62/70),对涂阳培阳标本检出率为93.9%(62/66),对涂阴培阳标本检出率为100%(5/5)。33例涂阴痰标本PhaB法检测MTB阳性率(36.4%)高于培养法(15.2%),差异显著(2χ=5.14,P<0.05)。结论PhaB法检测测痰标本MTB具有较高的敏感性和特异性,只需要2天时间,简便快速,不需要特殊仪器设备,费用低廉,可作为MTB检测快速筛选方法。

Objective To study the application of phage amplified biologically （Phab） assay in fast detection of mycobacterium tuberculosis （MTB） in sputum. Methods MTB of 103 sputum specimens by Phab assay and L J medium culture were examined and the results from these two research were briefly compared. Results 67 positive acid - fast stained sputum specimens were found in the total of 103 sputum specimen by the two methods. 25 cases with negtive acid - fast stained sputum specimens were found in the 103 sputum specimens by the two methods. The test resuts were different in 11 cases of the 103 sputum specimens. The sensitivity, specificity, positive and negative predictive values as well as overall accuracy for the PhaB assay were 94. 9% （67/71）, 73.5% （25/34）, 90. 5% （67/74）, 86.2% （25/29）, 89.3% （92/103） respectively if the judgment standard was adopted by L J medium culture. The detection rate of MTB in the smear-positive, smear-positive and culture-positive, smear-negtive and culture-positive sputum was 88.6% （62/70）, 93.9 % （62/66） and 100% （5/5） with Phab assay. The positive rate of MTB （36. 4% ） in 33 smear-negtive sputum by Phab assay was higher than that of MTB （ 15.2% ） by L J medium culture： Х^2 = 5.14,P 〈 0.05. Conclusion The PhaB assay can be used for rapid detection of MTB in sputum easily and quickly within two days. This method does not need special instrument with high sensitivity, high specificity and low cost.