离心浓缩涂片法检测抗酸杆菌的临床应用价值

Clinical applicable value of centrifugal concentration smear method in determination of acid-fast bacilli

目的评价离心浓缩涂片法在检测抗酸杆菌中的应用价值。方法应用离心浓缩涂片法检测926例临床标本,并与直接涂片法、BACTEC MGIT-960培养法结果进行比较。结果离心浓缩涂片法的阳性检出率30.9%,显著高于直接涂片法的19.1%(x^2=34.2,P<0.01),而接近于BACTEC MGIT-960培养法的32.7%(x^2=0.72,P>0.05),而且检测时间明显缩短为4 h;以BACTEC MGIT-960培养结果为金标准,离心浓缩涂片法的敏感性为84.8%(257/303),特异性为95.3%(594/623),准确性为91.9%(851/926)。结论离心浓缩涂片法检测抗酸杆菌简便快速,较直接涂片法检测阳性率有显著提高,具有很高的敏感性和特异性,适合基层实验室推广应用。

Objective To evaluate the clinical applicable value of centrifugal concentration smear method in determination of acid-fast bacilli （AFB）. Methods Centrifugal concentration smear method was used to determine AFB in 926 clinical specimens, the results were compared with those with direct smear method and BACTEC MGIT-960 rapid cultivation method. Results The positive detection rate of centrifugal concentration smear method was 30.9%, significantly higher than that of direct smear method （19.1%） （X2 =334.2,P〈0.01） and closed to that of BACTEC-960 cultivation method （32. 7%） （X2 = 0. 72, P〉0.05）. Moreover, the testing time evidently shortened to 4 hours. With the BACTEC MGIT-960 cultivation result as the gold standard, the sensitivity of centrifugal concentration smear method was 84. 8% （257/303）, the specificity was 95. 3% （594/623） and the accuracy was 91.9% （851/926）. Conclusion Centrifugal concentration smear method is convenient and rapid in checking acid-fast bacilli, which has higher positive detection rate, sensitivity and specificity, suitable for spread and application in basic level laboratories.