TB-LAMP、Xpert MTB/RIF及罗氏固体培养在肺结核诊断中的比较  被引量:15

Comparison of TB-LAMP,Xpert MTB/RIF and Roche solid culture in the diagnosis of pulmonary tuberculosis

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作  者:刘权贤 王鸿 陈玲[1] 李瑜琴[1] 袁阳[1] 张建勇[1] LIU Quan-xian;WANG Hong;CHEN Ling;LI Yu-qin;YUAN Yang;ZHANG Jian-yong(Second Department of Respiratory Medicine,Affiliated Hospital of Zunyi Medical College,Zunyi,Guizhou 553000,China)

机构地区:[1]遵义医学院附属医院呼吸二科

出  处:《中国临床研究》2018年第12期1611-1613,共3页Chinese Journal of Clinical Research

基  金:国家自然科学基金(81760003)

摘  要:目的比较结核分枝杆菌环介导核酸等温扩增技术(TB-LAMP)、利福平耐药实时荧光定量核酸扩增技术(Xpert MTB/RIF)及罗氏固体培养三种检测技术对活动性肺结核诊断的应用价值。方法收集活动性肺结核患者痰标本152份(涂阳标本80份,涂阴标本72份),分别行TB-LAMP法、Xpert MTB/RIF和罗氏固体培养检测结核分枝杆菌。结果在涂阳痰标本80例中,MTB阳性率LAMP检测为98.8%,Xpert MTB/RIF检测为95.0%,罗氏固体培养为85. 0%;三种检测方法阳性率比较差异无统计学意义(P>0. 05)。在涂阴痰标本72例中,MTB阳性检出率LAMP检测为31.9%,Xpert MTB/RIF检测为25.0%,罗氏固体培养为16.7%,三种检测方法阳性率比较差异有统计学意义(P<0. 05),LAMP技术MTB阳性检出率最高,Xpert MTB/RIF检测次之,罗氏培养的检出率最低。结论对涂阳肺结核痰标本,TB-LAMP、Xpert MTB/RIF与罗氏培养在MTB的检出上具有同等效能;对涂阴肺结核痰标本,TB-LAMP、Xpert MTB/RIF检测优于罗氏培养,相对于Xpert MTB/RIF,TB-LAMP因简便、快速、价廉,更适用于发展中国家或地区对肺结核病的诊断及防控。Objective To compare the application value of loop-mediated isothermal amplification for tuberculosis( TBLAMP),Xpert Mycobacterium tuberculosis( MTB)/rifampicin( RIF) assay,and Roche solid culture in diagnosis of active pulmonary tuberculosis. Methods A total of 152 sputum specimens were collected from the patients with active pulmonary tuberculosis( 80 smear-positive specimens and 72 smear-negative specimens). MTB was respectively detected by TBLAMP,Xpert MTB/RIF and Roche solid culture. Results In 80 smear-positive sputum samples,the positive rates of MTB detected by TB-LAMP,Xpert MTB/RIF and Roche solid culture were 98. 8%,95. 0% and 85. 0% respectively. There was no significant difference in the positive rate by three methods( P > 0. 05). In 72 smear-negative sputum specimens,the positive rates of MTB detected by TB-LAMP,Xpert MTB/RIF and Roche solid culture were 31. 9%,25. 0% and 16. 7%respectively. There was significant differencein the positive detection rates among the three methods( P<0. 05). The positive rate detected by LAMP was the highest,followed by Xpert MTB/RIF,and the lowest by Roche culture. Conclusion TBLAMP,Xpert MTB/RIF and Roche culture have the same effect in detecting MTB for smear-positive pulmonary tuberculosis spatum specimens. TB-LAMP and Xpert MTB/RIF are better than Roche culture for smear-negative tuberculosis sputum specimens. Compared with Xpert MTB/RIF,TB-LAMP is more suitable for diagnosis,prevention and control of pulmonary tuberculosis in developing countries or regions because of its simplicity,rapidity and low cost.

关 键 词:结核分枝杆菌环介导核酸等温扩增技术 利福平耐药实时荧光定量核酸扩增技术 结核菌培养 诊断 肺结核 

分 类 号:R521[医药卫生—内科学] R446.5[医药卫生—临床医学]

 

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