线性探针技术在耐多药结核病诊断中的应用评价

Application and evaluation of line probe assay in the diagnosis of multidrug-resistant tuberculosis

目的评价线性探针技术诊断临床耐多药结核病（MDR-TB）的价值。方法收集临床分离的结核分枝杆菌菌株268例,采用比例法药敏试验和线性探针技术检测利福平和异烟肼的耐药性,以比例法药敏试验为金标准,分析线性探针方法检测的敏感度、特异度。结果与比例法药敏试验相比,线性探针技术检测耐利福平敏感度为88.89%,特异度为98.05%,耐药检出率差异无统计学意义（χ^2=0.82,P〉0.05）;耐异烟肼敏感度为84.61%,特异度为97.69%,耐药检出率差异无统计学意义（χ^2=0.69,P〉0.05）;诊断MDR-TB的敏感度为78.26%,特异度为96.85%,耐多药检出率差异无统计学意义（χ^2=0.53,P〉0.05）。结论线性探针技术敏感度和特异度高,可用于MDR-TB的早期诊断。

Objective To evaluate the application value of line probe assay in the diagnoses of multidrug-resistant tuberculosis（MDR-TB）.Methods 268 strains of clinically isolated M.tuberculosis were collected.The ratio method drug susceptibility test and line probe assay were adopted for detecting the resistance of rifampin（RFP）and isoniazid（INH）.Using the ratio method of the drug susceptibility test as gold standard,the sensitivity and specificity of line probe assay were analyzed and compared with those by the traditional drug susceptibility test.Results Conpared with the ratio method drug susceptibility test,the sensitivity and specificity of the line probe assay were88.89% and 98.05%for detecting RIF resistance and 84.61%and 97.69%for detecting INH resistance,respectively,there was no statistically significant difference between the two methods（χ~2=0.82,P0.05;χ~2=0.69,P0.05）.The sensitivity and specificity of line probe assay for diagnosing MDR-TB detecting were 78.26% and96.85% respectively,the difference in multiple drug resistance rate had no statistical significance（χ~2=0.53,P0.05）.Conclusion The line probe assay is a reliable method with high sensitivity and high specificity and can be used for the early diagnosis of MDR-TB.