3种方法检测痰标本结果临床应用对比分析

Comparison of three methods to detect the clinical application of sputum specimens

目的探讨痰液用涂片抗酸染色法、固体培养法和Xpert MTB/RIF检测技术3种方法检测痰结核分枝杆菌的阳性率对比。方法对350份疑似结核病人、150份临床确诊病人和80份非结核病人的痰标本分别做涂片抗酸染色法、固体培养法和Xpert MTB/RIF检测,并将结果进行比较。结果 350份痰标本中3种方法检测其中涂片检查阳性70份,阳性率为20.0%;固体培养阳性133份,阳性率为38.0%,Xpert MTB/RIF检测阳性154份,阳性率为44.0%;150份肺结核病人和80份非肺结核病人痰标本3种方法敏感性分别为19.2%(30/156)、34.6%(54/156)、46.1%(72/156)、0.0%(0/2)、0.0%(0/2)、100.0%(2/2)。80份非结核病人的痰标本中只有Xpert MTB/RIF检测技术检测出2份涂阳,且显示极其微量的结核菌阳性。结论 3种方法阳性检出率Xpert MTB/RIF检测技术最高,固体培养法次之,涂片染色法最低。建议在临床诊断结核中优先使用固体培养法和Xpert MTB/RIF法检测。

Objective To investigate the positive rate of sputum Mycobacterium tuberculosis by sputum smear acid fast staining,solid culture and Xpert MTB/RIF detection techniques in three cases. Methods 350 cases of suspected tuberculosis patients and150 cases of clinically diagnosed cases and 80 non tuberculosis patients with sputum smear acid fast staining respectively,solid culture method and Xpert/RIF and MTB detection,and the results were compared. Results Three methods of 350 cases of sputum smear positive were detected in 70 cases,the positive rate was 20%; solid culture was positive in 133 cases,the positive rate was 38. 0%,Xpert positive 154 cases,the positive rate was 44. 0%; the detection of 150 cases of pulmonary tuberculosis patients and 80 patients with non tuberculosis three methods were sensitive 19. 2%（ 30/156）,34. 6%（ 54/156） 46. 1%（ 72/156）,0. 0%（ 0/2）,0. 0%（ 0/2）,100. 0%（ 2/2）. 80 non tuberculosis patients with sputum is Xpert Mtb/RIF detection of 2 samples of smear positive cases,but also shows an extremely small amount of TB positive. Conclusion The positive detection rate of the three methods of Xpert MTB/RIF is the highest,the solid culture method is the second,and the smear staining method is the lowest. The positive rate of solid culture method and Xpert MTB/RIF method was significantly higher than that of sputum smear method. It was suggested that the solid culture method and Xpert MTB/RIF method should be used in the diagnosis of tuberculosis.