噬菌体生物扩增法检测结核杆菌在HIV／AIDS合并结核感染快速诊断中的应用

Application of PhaB for Rapidly Diagnosis of HIV-TB Co-infection

目的探讨噬菌体生物扩增法检测结核分支杆菌在HIV／AIDS合并结核感染快速诊断中的应用价值。方法收集本院艾滋病区和艾滋病咨询门诊HIV／AIDS患者的痰、支纤镜抽取液、穿刺液、脓液标本共126份，应用噬菌体生物扩增法检测结核分支杆菌，同时作抗酸染色、并用Versa TREK^TM细菌培养仪做分支杆菌培养。噬菌体生物扩增法和／或培养阳性的菌株44株做分支杆菌菌种鉴定。结果噬菌体生物扩增法检测的阳性率32．5％（41／126）显著高于涂片法17．4％（22／126），（P〈0．01），与VersaTREK^TM培养法阳性率30．2％（38／126）相比，无显著性差异（P〉0．05）。35株VersaTREK^TM培养法与噬菌体生物扩增法同时阳性的菌株和6株噬菌体生物扩增法阳性菌株均鉴定为结核分支杆菌；3株VerSaTREK^TM培养法阳性菌株鉴定为非结核分支杆菌。结论噬菌体生物扩增法检测结核分支杆菌具有快速、特异、敏感的特点，在HIV／AIDS合并结核感染的快速诊断中有重要价值。

Objective To evaluate the value of rapid detection for mycobacterium tuberculosis with phage biological amplification in HIV/AIDS patients complicated by tuberculosis infection. Methods 126 clinical specimen of sputum, bronchoscopic abstracts obtained fluid, puncture fluid, or liquor puris from the HIV/AIDS patients were detected by phage biological amplification, acid-fast staining, and VersarREK^TM bacterial culure. The positive 44 strains by phage biological amplification and VersaTREK^TM culure were to make mycobacterium identification. Results The positive rates with phage biological amplification, smears test, and VersaTREK^TM bacterial culure were 32.5% （41/126）, 17.4% （22/126）, and 30.2% （38/126）, respectively. The positive rate with phage biological amplification was significant higher than that of smears test （P〈0.01）. There was no difference between phage biological amplification and VersarREK^TM culure （P〉0. 05）. 35 strains from the positive 38 strains by VersarREK^TM culure were identified to be mycobacterium tuberculosis and the specificity was 92.1%. As for phage biological amplification, 41 strains were all identified to be mycobacterium tuberculosis and the specificity was 100% Conclusion The phage biological amplification for mycobacterium tuberculosis is rapid, specific and sensitieve, so it is important in the rapid detection of HIV/AIDS patients complicated by tuberculosis infection.