Cyscope荧光显微镜技术用于结核病检测的临床应用评价

Clinical evaluation of the effects of Cyscope flourescent microscopy for detecting tuberculosis

目的评价Cyscope荧光显微镜技术用于结核病检测的临床诊断价值。方法收集拟诊肺结核病人痰标本,分别用金胺-罗丹明染色发光二极管Cyscope荧光显微镜涂片检查(LED荧光法)、萋尼氏抗酸染色明场显微镜涂片检查(萋尼法)、改良罗氏培养基培养(罗氏培养法)和BACTEC MGIT960快速培养系统培养(BACTEC MGIT960法)进行检测。将LED荧光法与其他3种方法的检测结果进行比较。结果本研究共收集、检测拟诊肺结核病病人痰标本106份。LED荧光法、萋尼法、罗氏培养法和BACTECMGIT960法的阳性检出率分别为31.13%、26.42%、39.62%和45.28%。以罗氏法为金标准,LED荧光法与萋尼法的灵敏度分别为69.05%和64.29%,χ2值为0.17,P值为0.687,差异无统计学意义,而特异性分别为95.08%和100.00%。以BACTEC MGIT960法为金标准,LED荧光法与萋尼法的灵敏度分别为60.42%和54.17%,特异性分别为93.10%和96.55%,χ2值分别为0.80和0.17,P值分别为0.375和0.687,差异均无统计学意义。LED荧光法与罗氏培养法和BACTEC MGIT960法的一致率分别为84.47%和78.30%。结论 Cyscope荧光法较准确,并且镜检敏感、快速,是目前诊断结核病的一种较为理想的检测方法。

Objective To evaluate the clinical application value of Cyscope flourescent microscopy for the diagnosis of tuberculosis.Methods The sputum specimen from patients suspected with pulmonary tuberculosis were collected from Nanchang,Jiangxi province and detected for Mycobacterium by Cyscope fluorescent microscopy smear（LED-FM）,Zeihl-Neelsen light microscopy smear（ZN）,L-J solid culture and BACTEC MGIT960 culture system.Results The positive rates for the detection of Mycobacterium were 31.13%,26.42%,39.62% and 45.28% by LED-FM,ZN,L-J solid culture and BACTEC MGIT960 culture system, respectively.Using the results of L-J solid culture as gold standard,the sensitivity of LED-FM and ZN were 69.05% and 64.29%,respectively,and the specificity were 95.08% and 100.00%,respectively.Using the results of BACTEC MGIT960 culture system as gold standard,the sensitivity of LED-FM and ZN were 60.42% and 54.17%,respectively,and the specificity were 93.10% and 96.55%,respectively.There was no significant difference between LED-FM and ZN.The concordance rates between LED-FM and L-J solid culture and BACTEC MGIT960 culture system were 84.47% and 78.30%,respectively .Conclusion Cyscope fluorescent microscopy smear is a good method for detection of Mycobacterium,and it is quick and sensitive.