改良抗酸染色法在检测痰结核分枝杆菌中的应用

The Clinical Application of Modified Ziehl-Neelsen Stain on the Detection of Mycobacterium Tuberculosis in Sputum

目的比较痰涂片传统抗酸染色、改良抗酸染色、BACTEC MGIT 960培养和Xpert MTB/RIF技术四种方法检测痰中结核分枝杆菌对于肺结核的诊断价值。方法 207例确诊结核患者和145例其他肺部感染患者的痰液,分别用痰涂片传统抗酸染色法、改良抗酸染色法、BACTEC MGIT 960培养及Xpert MTB/RIF技术检测抗酸杆菌,比较四种方法的灵敏度及特异性。结果痰涂片传统抗酸染色法、改良抗酸染色法、BACTEC MGIT 960培养和Xpert MTB/RIF技术检测痰中结核分枝杆菌的敏感度分别为20.3%、59.9%、55.6%和69.1%;特异性分别为99.3%、99.3%、100%和99.3%。结论与传统抗酸染色法、BACTEC MGIT 960培养和Xpert MTB/RIF技术相比,改良抗酸染色法具有简单、快速、敏感性高、特异性强和成本低廉等优点,是临床肺结核快速诊断的有效检测方法,值得基层实验室推广。

Objective To compare the application values of sputum smear microscopy,modified Ziehl-Neelsen stain,BACTEC MGIT 960 culture and Xpert MTB/RIF assay for the detection of Mycobacterium tuberculosis（MTB）in the diagnosis of pulmonary tuberculosis（PTB）. Methods Sputum samples from 207 patients with PTB and 145 control cases were detected for the MTB by sputum smear microscopy,modified Ziehl-Neelsen stain,BACTEC MGIT 960 culture and Xpert MTB/RIF assay,respectively. The sensitivities and specificities of the four methods were then compared. Results The sensitivities of sputum smear microscopy,modified Ziehl-Neelsen stain,BACTEC MGIT 960 culture and Xpert MTB/RIF assay were 20. 3%,59. 9%,55. 6%and 69. 1%,while the specificities were 99. 3%,99. 3%,100% and 99. 3%,respectively. Conclusion Compared with sputum smear microscopy,BACTEC MGIT 960 culture and Xpert MTB/RIF assay,the modified Ziehl-Neelsen stain is a simple,rapid,sensitive,specific and cost effective mehtod for detecting MTB,which can be utilized for early and rapid diagnosis of PTB.