两种痰标本分子检测方法诊断菌阴肺结核的价值

Comparison of two molecular method for the diagnosis of smear-negative pulmonary tuberculosis

目的探讨痰标本分子检测方法利福平耐药实时荧光定量核酸扩增(XpertMTB/RIF)和恒温扩增荧光检测试剂盒(RealAmp)在菌阴肺结核快速诊断中的应用价值。方法研究组选取2014年10月~2015年10月永城市结核病防治所确诊的涂阴肺结核患者91例;对照组选取同一时期就诊期间诊断为肺部其他疾病患者31例,两组均进行XpertMTB/RIF和RealAmp检查,比较两种方法的敏感性、特异性。结果菌阴肺结核组痰XpertMTB/RIF和RealAmp的敏感性分别为70.3%,60.4%;XpertMTB/RIF和RealAmp相比明显差异无统计学意义(P>0.05);特异性分别为93.5%,83.9%。结论痰XpertMTB/RIF和RealAmp两种检测方法在菌阴肺结核诊断中都具有较高的灵敏度和特异性在临床中应用能提高菌阴肺结核的病原学检出率。

Objective To evaluate the performance of Xpert MTB/RIF and RealAmp to detect the smear-negative pulmonary tuberculosis. Methods 91 patients were enrolled, from November of 2014 to November of 2015 at the tubercular clinical of Yong cheng,31 cases of other lung diseases were selected as the control group during the same period.Two groups were tested by Xpert MTB/RIF and RealAmp, the corresponding sensitivity, specificity were calculated and compared. Results The sensitivity was 70.3 % and 60.4 % for Xpert MTB/RIF and RealAmp, respectively. There was no significant difference between the two methods(P>0.05). The specificity was 93.5 % and 83.9 % for Xpert MTB/RIF and RealAmp, respectively. Conclusions Xpert MTB/RIF and RealAmp have good performance in the detection of smear-negative pulmonary tuberculosis. Application of these methods in clinical will shorten the time for the detection of smear-negative pulmonary tuberculosis and improve the detection accuracy.