LAMP技术在基层结核病诊疗机构推广应用研究  

Application and popularization of LAMP technology at TB control institutions

作　　者：黄文焰[1] 刘开钳[1] 陈伊[1] 梅金周 陈文胜[1] 王云霞[1] 张梅娟 谢玉爱 黄玲[1] 

机构地区：[1]深圳市宝安区慢性病防治院,广东深圳518000

出　　处：《中国热带医学》2017年第12期1264-1266,共3页China Tropical Medicine

基　　金：深圳市宝安区社会公益项目(No.2016CX223)

摘　　要：目的探讨环介导等温扩增法(loop-mediated isothermal amplification,LAMP)快速检测结核分枝杆菌技术在基层结防机构推广应用的可行性。方法选取深圳市宝安区疑似肺结核初诊患者300例,分别采用抗酸染色涂片法、L-J罗氏培养法及LAMP法检测痰标本中结核分枝杆菌。采用卡方检验和Kappa检验分析三种检测方法的一致性,以P<0.05为差异有统计学意义。结果 300例痰标本中,抗酸染色涂片法、L-J改良罗氏培养法和LAMP法的阳性检出率分别为13.7%(41/300)、20.7%(62/300)和22.0%(66/300);LAMP法灵敏度、特异度和诊符率分别为44.2%(61/138)、96.9%(157/162)、72.3%(218/300)。同改良罗氏培养法相比,Kappa值=0.94,P=0.219,差异无统计学意义。与涂片法相比,Kappa值=0.674,P<0.001差异有统计学意义。结论 LAMP法用于痰标本中结核分枝杆菌检测,其效能同罗氏培养法相当,同直接涂片法相比,LAMP法能够大幅提高阳性检出率,且技术操作较简便,具有较好的临床应用和推广前景。Objective To discuss the feasibility of application and popularization of a loop-mediated isothermalamplification（LAMP） method for rapid detection of Mycobacterium tuberculosis at tuberculosis（TB） control institutions.Methods A total of 300 cases of suspected tuberculosis in Baoan District of Shenzhen City were selected. The anti-acidstaining method, L-J modified Roche culture method and LAMP method were used to detect Mycobacterium tuberculosis insputum specimens. Results In 300 sputum specimens, the positive rates of anti-acid staining, L-J modified Roche cultureand LAMP were 13.7%（41/300）, 20.7%（62/300） and 22.0%（66/300） respectively. The sensitivity, specificity and diagnosticrate of the LAMP method were 44.2%（61/138）, 96.9%（157/162） and 72.3%（218/300） respectively. Compared with the L-Jmodified Roche culture method, kappa=0.94, P=0.219, there was no significant difference. Compared with the method ofsmear, kappa=0.674, P〈0.001, there was a significant difference. Conclusions The LAMP method to detect Mycobacterium tuberculosis in sputum specimens is equivalent to the L-J modified Roche culture method. Compared with the direct smearmethod, the LAMP method can greatly improve the positive detection rate, and its operation is simple. It has a good clinicalapplication and popularization prospect.

关 键 词：结核分枝杆菌 环介导等温扩增 快速检测 

分 类 号：R52[医药卫生—内科学]