CAJ | 학술논문

目的评估RNA恒温扩增实时荧光检测技术(SAT)在肺结核诊断中的应用.方法采用SAT、罗氏培养法、萋尼法同时对277份痰标本进行检测,采用x2检验比较SAT与另2种方法对痰标本中结核分枝杆菌检出的阳性率;分别以临床诊断和罗氏培养为标准计算治疗前和治疗后SAT检测的灵敏度、特异性、阳性预测值(PPV)和阴性预测值(NPV).结果 SAT、罗氏培养法、萋尼法对277份痰标本检测的阳性率分别是47.3％ (131/277)、30.3％(84/277)、29.6％(82/277),SAT检测的阳性率与罗氏培养法(x2=16.8,P＜0.05)和萋尼法(x2=18.3,P＜0.05)比较,差异具有统计学意义.治疗前以临床诊断为标准,SAT的灵敏度、特异性、PPV、NPV分别是59.0％ (95/161)、97.4％(37/38)、99.0％(95/96)、35.9％(37/103);治疗后以罗氏培养为标准,SAT的灵敏度、特异性、PPV、NPV分别是11/11、64.2％ (43/67)、31.4％ (11/35)、100％ (43/43).结论 SAT对痰中结核分枝杆菌具有较高的敏感度,可辅助肺结核的早期诊断,能明显缩短治疗后活菌的检测周期,辅助疗效判断,为治疗方案的早期调整提供参考.
목적 평고RNA항온확증실시형광검측기술(SAT)재폐결핵진단중적응용.방법 채용SAT、라씨배양법、처니법동시대277빈담표본진행검측,채용x2검험비교SAT여령2충방법대담표본중결핵분지간균검출적양성솔;분별이림상진단화라씨배양위표준계산치료전화치료후SAT검측적령민도、특이성、양성예측치(PPV)화음성예측치(NPV).결과 SAT、라씨배양법、처니법대277빈담표본검측적양성솔분별시47.3％ (131/277)、30.3％(84/277)、29.6％(82/277),SAT검측적양성솔여라씨배양법(x2=16.8,P＜0.05)화처니법(x2=18.3,P＜0.05)비교,차이구유통계학의의.치료전이림상진단위표준,SAT적령민도、특이성、PPV、NPV분별시59.0％ (95/161)、97.4％(37/38)、99.0％(95/96)、35.9％(37/103);치료후이라씨배양위표준,SAT적령민도、특이성、PPV、NPV분별시11/11、64.2％ (43/67)、31.4％ (11/35)、100％ (43/43).결론 SAT대담중결핵분지간균구유교고적민감도,가보조폐결핵적조기진단,능명현축단치료후활균적검측주기,보조료효판단,위치료방안적조기조정제공삼고.
Objective To evaluate the value of simultaneous amplification and testing method for diagnosing in patients with pulmonary tuberculosis.Methods Total of 277 sputum samples were detected by SAT,Lowenstein-Jensen (L-J) culture and Ziehl-neelsen staining.Chi-square test was used to compare and analysis the statistical difference in positive detection rates.The sensitivity,specificity,positive predictive value (PPV) and negative predictive value (NPV) of SAT for early diagnosing and judging curative effect were calculated respectively when the clinical diagnosis and L-J culture used as its reference standard.Results The positive detection rates of the three methods for detecting Mycobacterium tuberculosis from the 277 sputum samples were 47.3％ (131/277),30.3％ (84/277),29.6％ (82/277),there was a significant difference between SAT and L-J culture(x2 =16.8,P ＜ 0.05)and Ziehl-neelsen(X2 =18.3,P ＜ 0.05)by chi-square test.Before treatment was commenced,using clinical diagnosis as its reference,the sensitivity,specificity,PPV and NPV of SAT were 59.0％ (95/161),97.4％ (37/38)、99.0％ (95/96) and 35.9％ (37/103) ; After intensive treatment was over,taking culture as its standard,the results were 11/11,64.2％ (43/67),31.4％ (11/35),100％ (43/43).Conclusions SAT can be useful for early diagnosis of clinically suspicious TB case,it has a more sensitive detecting values of SAT for living bacilli and a shorter test period,which implied it can help judging the response to anti-TB treatment.