痰结核分枝杆菌DNA检测诊断肺结核的临床意义

Clinical significance of sputum Mycobacterium tuberculosis DNA in the diagnosis of pulmonary tuberculosis

目的评估痰结核分枝杆菌DNA检测诊断肺结核的可行性及临床意义。方法回顾性分析2016年5月—12月在我科住院的经痰结核分枝杆菌培养确诊的136例肺结核患者的临床资料,比较痰涂片找抗酸杆菌和痰结核分枝杆菌DNA检测2种方法的检出率。结果 136例确诊的肺结核患者中,痰涂片阳性的有64例(47.06%),痰结核分枝杆菌DNA检测阳性的88例(64.71%),痰结核分枝杆菌DNA检测阳性率明显高于痰涂片找抗酸杆菌(P<0.05)。72例痰涂片阴性患者中痰结核分枝杆菌DNA检测阳性29例,占痰涂片阴性肺结核患者比例的40.28%。结论痰结核分枝杆菌DNA检测优于痰涂片找抗酸杆菌,能够辅助涂阳肺结核的诊断,并提高涂阴肺结核的诊断水平,是一种快速、敏感的病原学诊断方法。

Objective To evaluate the feasibility and clinical significance of sputum Mycobacterium tuberculosis DNA in the diagnosis of pulmonary tuberculosis.Methods We retrospectively analyzed 136 patients with tuberculosis who were hospitalized in our department from May 2016 to December 2016,to compare the detection rate of sputum smear looking for Acidfast bacillus and sputum Mycobacterium tuberculosis DNA test methods.Results Sixty-four cases(47.06%)were positive for sputum smear and 88 cases(64.71%)were positive for sputum Mycobacterium tuberculosis among 136 patients with confirmed pulmonary tuberculosis.The positive detection rate of Mycobacterium tuberculosis DNA was significantly higher than that of sputum smear(P<0.05).Among the 72 sputum smearnegative patients,29 cases were positive for sputum Mycobacterium tuberculosis DNA,accounting for 40.28%of the total number of sputum smear-negative pulmonary tuberculosis patients.Conclusions Mycobacterium tuberculosis DNA detection is superior to sputum smear looking for Acidfast bacillus.It can assist the diagnosis of smear-positive pulmonary tuberculosis and increase the diagnosis rate of smear-negative pulmonary tuberculosis.It is a rapid and sensitive etiological diagnosis method.