痰模型及目测涂片法检测抗酸杆菌的比较研究  

Comparison with sputum smear by control membrane model and sputum smear by sight in detecting mycobacteria

作　　者：刘庆福[1] 刘予东[2] 严秀丽[2] 

机构地区：[1]泰安市结核病防治中心参比实验室,271000 [2]泰安市泰山区疾病预防控制中心结核病防治科

出　　处：《中国防痨杂志》2012年第6期364-368,共5页Chinese Journal of Antituberculosis

基　　金：泰安市科技发展计划(20113060)

摘　　要：目的评价痰模型涂片法检测抗酸杆菌的价值。方法对1089份初诊为活动性肺结核患者的痰标本,分别应用模型涂片法、目测涂片法检测抗酸杆菌,并与罗氏培养结果进行比较。检测结果比较采用χ2检验和秩和检验,以P<0.05为差异有统计学意义。结果模型涂片法阳性检出率31.68%(345/1089),高于目测涂片的24.24%(264/1089)(χ2=14.955;P<0.05),模型涂片法与目测涂片法的质量指标合格率分别为痰细胞(94.21%,86.41%)、痰膜大小(98.99%,75.30%)、厚薄(96.14%,74.29%)、染色(94.49%,87.60%)、痰膜脱落(97.43%,86.41%),较目测涂片法均明显提高(χ2值分别为37.915、272.799、206.432、31.683、89.011,P值均=0.001)。以罗氏培养结果为标准,模型涂片法灵敏度为82.69%(344/416),Kappa值为0.853,优于目测涂片法[灵敏度为63.46%(264/416),Kappa值为0.682],说明模型涂片法与罗氏培养法具有较好的一致性。结论模型涂片既继承了目测涂片检测抗酸杆菌的简便快速,又较目测涂片制片质量和阳性检出率明显提高,具有较高的敏感度、特异度,适合基层实验室推广应用。Objective To evaluate the value of the sputum smear by control membrane model in detecting mycobacteria.Methods 1089 sputum samples from new patients diagnosed with active pulmonary tuberculosis were detected mycobacteria with the sputum smear by control membrane model and the sputum smear by sight.We compared them with Lowenstein-Jensen（L-J） culture method.Results The positive rate was 31.68%（345/1089）in sputum smear by control membrane model.It was higher than that（24.24%,264/1089）in sputum smear by sight（χ2=14.955;P0.05）,but was close that in the L-J culture（38.20%,416/1089）（Z=-8.310,P=0.001）.The quality of the sputum smear by control membrane model was improved in cells of sputum smear,sputum membrane size,sputum membrane thickness,acid fast stain and sputum membrane falling off.With the L-J culture as stan-dard,the sensitivity and kappa value of sputum smear by control membrane model were 82.69%（344/416）and 0.853,respectively.They were better than those（63.46%,0.680） of sputum smear by sight.It showed that there were consistent with the sputum smear by control membrane model and the L-J culture.Conclusion The sputum smear by control membrane model is not only simple and rapid but also high quality in smear and high positive rate.It is suit for microscopy laboratory application.

关 键 词：分枝杆菌 结核 痰 细菌学技术 

分 类 号：R446.5[医药卫生—诊断学]