发光二极管荧光适配器显微镜的实验室诊断效果评价

Evaluation of Light Microscopy Using Light Emitting Diodes Adaptor in Detecting Acid-fast Bacilli

目的评价发光二极管荧光适配器显微镜检测痰涂片抗酸杆菌的检查效率。方法收集552份结核病患者或疑似患者的痰标本，以及40份来自体检者的痰标本，综合罗氏培养和显微镜检查结果，比较普通光学显微镜、传统汞灯荧光显微镜（FM）、普通发光二极管荧光显微镜（LED1）、安装了发光二极管荧光适配器的光学显微镜（LED2）在痰涂片检查抗酸杆菌方面的敏感性和特异性。结果在150份罗氏培养阳性的痰标本中，光学显微镜法、FM法、LEDI法、LED2法检查的敏感性分别为52．7％（79／150）、66．O％（99／150）、66．7％（100／150）、67．3％（101／150）；在所有173份菌阳痰标本中，光学显微镜法、FM法、LED1法、LED2法的敏感性分别为51．4％（89／173）、68．2％（118／173）、67．6％（117／173）、65．9％（114／173）。40份来自体检者的痰标本培养均为阴性，四种显微镜涂片检查结果均为阴性，即特异性均为100％。结论传统荧光显微镜和2种发光二极管荧光显微镜较普通光学显微镜在痰查抗酸菌的敏感性方面均存在明显优势护〈0．05）；2种LED显微镜之间，2种LED显微镜与传统荧光显微镜之间，无论是在痰查抗酸菌的敏感性方面还是特异性方面均无差异（P〉0．05）。

Objective To assess the efficency of light microscopy using light emitting diodes （LED） adaptor in detecting acid-fast bacilli（AFB） from sputa. Methods 552 sputa from TB patients or TB suspects and 40 sputa from person who underwent physical examination were collected. The sensitivities and specificities of different methods including light microscopy Ziehl-Neelsen （ZN）, conventional fluorescence microscopy （FM）, conventional LED fluorescence microscopy （LED 1）, and light microscopy using LED adaptor （LED2） were compared in detecting acid-fast bacilli based on the results of L-J media culture and microscopy. Results Among 150 L-J culture positive sputa samples, the sensitivities for light microscopy, FM, LED1 and LED2 were 52.7 % （79/150）, 66.0 % （99/150）, 66.7 % （100/150）, 67.3 % （101/150）, respectively. Among 173 bacilli positive samples, the sensitivities were 51.4 % （89/173）, 68.2 % （118/173）, 67.6 % （117/173）, 65.9 % （114/173） correspondingly. All the 40 sputa collected from people who underwent physical examination were culture negative, and the specificities for all the 4 types of microcopy examination are all 100%. Conclusions Conventional fluorescence microscopy, conventional LED fluorescence microscopy, and light microscopy using LED adaptor had better efficency in detecting AFB than light microscopy （P〈0.05）. No significant difference were observed among conventional fluorescence microscopy and 2 kinds of LED microcopy （P〉0.05）.