重庆市肺结核患者病原学检出情况

Pathogenic detection of patients with pulmonary tuberculosis in Chongqing

目的分析重庆市肺结核患者病原学阳性检出情况,为进一步提高重庆市结核病原学阳性率,及时发现患者提供依据。方法对重庆市25个区县结核病实验室的痰标本合格率、涂片阳性率、培养阳性率、分子检测阳性率、分子检测开展时间及分子检测质量6项指标进行调查,从结核病信息管理系统导出各区县病原学阳性率数据,分别比较分析各项指标不同情况下的病原学阳性率情况。结果痰标本合格率≥60.0%组的病原学阳性率高于痰标本合格率<60.0%组,但差异无统计学意义(P>0.05)。涂片阳性率≥5.0%组的病原学阳性率高于涂片阳性率<5.0%者,但差异无统计学意义(P>0.05)。培养阳性率≥20.0%组的病原学阳性率高于培养阳性率<20.0%组,但差异无统计学意义(P>0.05)。分子检测阳性率≥50.0%组、分子检测开展时间≥6个月组及分子检测失败性率<5.0%组的区县,其病原学阳性率分别明显高于分子检测阳性率<50.0%组、分子检测开展时间≤1个月组及分子检测失败性率≥5.0%组(均为P<0.05)。结论开展分子生物学检测并保证检测质量,提高分子检测阳性率,是重庆市结核病实验室提高肺结核患者病原学阳性率的主要措施。

Objective To analyze the positive situation of pathogenic detection in patients with pulmonary tuberculosis(PTB) in Chongqing, in order to provide the basis for further improving the positive rate of pathogenic detection and timelydiagnosis.MethodsThe qualified rate of sputum specimen, positive rates of smear, culture and molecular detection, durationand quality of molecular detection in TB laboratories from 25 counties in Chongqing were investigated. From the TuberculosisInformation Management System(TBMIS), the data of etiology positive rate of each county in Chongqing was exported. Theetiology positive rates under different circumstances of various indicators were compared and analyzed.ResultsTheetiological positive rate of group with qualified rate of sputum specimen ≥60.0% were higher than those with qualified rate ofsputum specimen <60.0% group, but the difference was not statistically significant(P>0.05). The etiological positive rate ofgroup with smear positive rate ≥5.0% were higher than those with smear positive rate <5.0% group, but the difference was notstatistically significant(P>0.05). The etiological positive rate of group with culture positive rate ≥20.0% were higher than thosewith culture positive rate <20.0% group, but the difference was not statistically significant(P>0.05).The groups with positiverate of molecular detection more than or equal to 50.0%, duration of molecular detection more than or equal to 6 months andunsuccessful test rate less than 5.0%, of which the etiology positive rate were significantly higher than the groups with positiverate of molecular detection less than 50.0%, duration of molecular detection less than or equal to 1 month and unsuccessful testrate more than or equal to 5.0% respectively(P<0.05).ConclusionCarrying out molecular biological detection, assuring testquality and increasing the positive rate of molecular detection, are the main measures for laboratory to improve the etiologypositive rate of PTB in Chongqing.