环介导等温扩增技术联合结核分枝杆菌快速培养在涂阴肺结核中的诊断价值  

Diagnostic value of loop-mediated isothermal amplification(LAMP) combined with fast culture of mycobacterium tuberculosis in smear negative pulmonary tuberculosis

作　　者：陶峰[1] 顾超[1] 张齐[1] 

机构地区：[1]浙江省嘉兴市第一医院呼吸科,浙江嘉兴314000

出　　处：《中国现代医生》2017年第5期19-22,共4页China Modern Doctor

基　　金：浙江省嘉兴市科技计划项目(2015AY23011)

摘　　要：目的探讨环介导等温扩增技术(loop-mediated isothermal amplification metliod,LAMP,新型的核酸扩增技术)联合结核分枝杆菌快速培养(BACTEC MGIT 960,结核分枝杆菌检测仪)在痰涂片阴性肺结核中的诊断价值。方法收集疑似肺结核患者90例,随机分成A、B、C组,A组通过指南推荐涂阴肺结核诊断,B组通过LAMP确诊,C组通过LAMP联合BACTEC MGIT 960确诊,并给予抗结核治疗2个月后随访所有入组患者胸部CT变化情况,分别比较涂阴肺结核诊断方法、LAMP及LAMP联合BACTEC MGIT 960的诊断可靠性。结果涂阴肺结核指南推荐诊断阳性率40.0%,LAMP阳性率53.3%、联合检测阳性率60.0%,差异无统计学意义。联合检测敏感性88.9%,特异性91.7%均明显升高。结论在实际临床中,环介导等温扩增技术联合结核分枝杆菌快速培养(BACTEC MGIT 960)在痰涂片阴性肺结核诊断中特异性及敏感性高。Objective To investigate the diagnostic value of loop-mediated isothermal amplification method（LAMP, a new nucleic acid amplification technology） combined with fast culture of mycobacterium tuberculosis （BACTEC MGIT 960, mycobacterium tuberculosis detector） in smear negative pulmonary tuberculosis. Methods 90 patients with suspected pulmonary tuberculosis were randomly divided into group A, B and C. Group A was recommended to be given the diag- nosis of smear negative pulmonary tuberculosis under the guidance, group B was diagnosed by LAMP and group C was diagnosed by LAMP combined with BACTEC MGIT 960. They were then all given anti-tuberculosis therapy. After 2 months, all patients were followed up for the changes of chest CT. The reliability of the diagnosis of smear-negative pulmonary tuberculosis, LAMP and LAMP combined with BACTEC MGIT 960 were compared. Results The positive rate of smear negative pulmonary tuberculosis under the guidance was 40.0%, the positive rate of LAMP was 53.3%, and the combined positive rate was 60.0%. There was no statistically significant difference among the three groups. The sensitivity of combined test was 88.9% and the specificity was 91.7%, which were significantly increased for both. Conclusion In the clinical practice, the specificity and sensitivity of the diagnosis of LAMP combined with BACTEC MGIT 960 in smear negative pulmonary tuberculosis are high.

关 键 词：环介导等温扩增技术 BACTEC MGIT 960 涂阴肺结核 诊断 

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