LAMP技术在涂阴肺结核中的临床快速诊断价值

Rapid clinical diagnostic value of LAMP technology in smear-negative pulmonary tuberculosis

目的评估LAMP技术在涂阴肺结核中的临床快速诊断价值。方法选取2016～2017年我院临床确诊为肺结核的患者和非结核患者共270例进行LAMP法、痰涂片法及GeneXpert MTB/RIF检测。结果 LAMP法、痰涂片抗酸染色法及GeneXpert MTB/RIF在肺结核组的阳性率分别为48.8%、35.2%及52.4%。LAMP法在肺结核组与非结核组的阳性检出率比较,差异有统计学意义(P <0.05)。LAMP法与痰涂片抗酸染色在肺结核组中比较,阳性率差异有统计学意义(P <0.05)。LAMP法与GeneXpert MTB/RIF技术在肺结核组中比较,两方法一致性最佳,阳性率差异无统计学意义(P> 0.05)。在110例涂阴肺结核患者组中,以GeneXpert MTB/RIF为比较标准,LAMP法的敏感度为82.8%(24/29)、特异度为97.5%(79/81),总体一致率93.6%(103/110)。两种方法一致性相比,两者一致性最佳,阳性率差异无统计学意义(P> 0.05)。结论痰标本检测中LAMP法在涂阴肺结核快速检测方面具有良好的诊断效能,具有很好的临床应用价值。

Objective To evaluate the rapid clinical diagnostic value of LAMP technology in smear-nega-tive pulmonary tuberculosis.Methods A total of 270 patients with clinically confirmed pulmonary tuberculosis and non-tuberculous patients from 2016 to 2017 were selected for LAMP,sputum smear,and GeneXpert MTB/RIF.Results The positive rates of LAMP,sputum smear acid-fast staining and GeneXpert MTB/RIF in tuberculo-sis group were 48.8%,35.2%and 52.4%,respectively.The positive rate of LAMP in tuberculosis and non-tuberculo-sis group was statistically significant(P<0.05).The positive rate of LAMP and sputum smear in the pulmonary tuberculosis group was significantly different(P<0.05).Comparison of LAMP with GeneXpert MTB/RIF in the tuberculosis group showed the best agreement between the two methods,but with no significant difference regarding the positive rate(P>0.05).With GeneXpert MTB/RIF technology as the standard,the sensitivity of LAMP method was 82.8%(24/29);the specificity 97.5%(79/81),and the overall consensus rate 93.6%(103/110).The best agreement between the two methods was observed but there was no statistical difference in terms of the positive rate(P>0.05).Conclusion In sputum specimen test,LAMP technology has a good diagnostic efficacy in rapid detec-tion of smear-negative pulmonary tuberculosis,and it has good clinical application and promotion prospect.