MPB64免疫胶体金法在新发肺结核患者中的应用  

Application of MPB64 immune colloidal gold method in new patients with mycobacterium tubereulosis

作　　者：戴小丽 许燕燕[2] 刘涛[1] 侯彦强[1] Dai Xiaoli;Xu Yanyan;Liu Tao;Hou Yanqiang(Department of Laboratory,Central Hospital of Songjiang District,Shanghai 201600,China;Department of Pathology,Central Hospital of Songjiang District,Shanghai 201600,China)

机构地区：[1]上海市松江区中心医院检验科,201600 [2]上海市松江区中心医院病理科,201600

出　　处：《国际医药卫生导报》2021年第3期396-399,共4页International Medicine and Health Guidance News

摘　　要：目的对免疫胶体金法、痰涂片抗酸染色法以及上海市疾病预防控制中心结核分枝杆菌复合群(mycobacterium tuberculosis complex,MTC)菌群鉴定等3种检测结果进行比较,评价MPB64免疫胶体金法在疑似新发肺结核患者中的临床应用价值。方法选取2018年9月至2019年8月经MGIT 960液体分枝杆菌培养仪培养阳性的疑似新发肺结核患者210例,首先进行MPB64免疫胶体金法检测,然后将标本转种至固体中性罗氏培养基中,待菌落在固体培养基中长势良好时,将其送至上海市疾病预防控制中心结核病防治科进行分枝杆菌菌群鉴定(PNB法、TCH法和28℃培养试验)。最后,比较分析胶体金法与传统的痰涂片抗酸染色法在检测抗酸杆菌阳性率方面的差异,并比较胶体金法检测结果与上海市疾病预防控制中心菌群鉴定结果之间的差异,分析胶体金法在菌群鉴定方面的敏感性、特异性以及准确度。结果210例疑似新发患者中,痰涂片抗酸染色阳性率为48.57%(102/210),MPB64免疫胶体金法阳性率为90.00%(189/210)。经上海市疾病预防控制中心菌群鉴定,其中结核分枝杆菌复合群感染187例,阳性率为89.05%(187/210),非结核分枝杆菌复合群23例,占比为10.95%(23/210)。与上海市疾病预防控制中心菌群鉴定结果比较,胶体金法在确诊结核分枝杆菌复合群感染中的敏感性为97.86%(183/187),特异性为73.91%(17/23),准确度为95.24%(200/210)。结论MPB64免疫胶体金法作为一种敏感性、特异性、准确度均较高的结核分枝杆菌快速检测方法,操作简便、快速、无需特殊仪器设备,适合于各基层试验应用于肺结核病的临床诊断。Objective To evaluate the clinical value of MPB64 immune colloid gold method for patients suspected with new pulmonary tuberculosis by comparing the detection results of immune colloid gold method,sputum smear anti-acid staining method,and the identification of CDC Mycobacterium tuberculosis complex group in Shanghai.Methods Two hundred and ten patients suspected with new pulmonary tuberculosis and positive in MGIT 960 Mycobacterium were selected from September,2018 to August,2019.All the patients'samples were detected by MPB64 immune colloidal gold method,then were cultured in Roche solid neutral medium,and when the colony on the solid medium grew well,the samples were sent to Department of Tuberculosis Prevention,Shanghai CDC to identify mycobacterium strains by PNB,TCH,and 28℃culture test.The differences in the positive rates of acid fast bacilli between the colloidal gold method and the traditional sputum smear acid fast staining method and between the results of colloidal gold method and the results of Shanghai CDC identification were compared.The sensitivity,specificity,and accuracy of the colloidal gold method for identification of bacteria groups were analyzed.Results Among the 210 patients,the positive rate of sputum smear anti-acid staining was 48.57%(102/210),and that of MPB64 immune colloid gold method was 90.00%(189/210).The identification of Shanghai CDC flora showed that 187 cases had mycobacterium tuberculosis complex infection,and the positive rate was 89.05%(187/210);and 23 cases were non-tuberculosis mycobacterium complex group,accounting for 10.95%(23/210).Compared with the results of Shanghai CDC identification,colloidal gold method showed a sensitivity of 97.86%(183/187),a specificity of 73.91%(17/23),and an accuracy of 95.24%(200/210)in the diagnosis of mycobacterium tuberculosis complex infection.Conclusion MPB64 immune colloid gold method is a sensitive,specific,and accurate method for rapid detection of mycobacterium tuberculosis.It is simple and rapid,and does not need special instrum

关 键 词：MPB64 胶体金法 MGIT 960 结核分枝杆菌 快速诊断 

分 类 号：R521[医药卫生—内科学] R446.6[医药卫生—临床医学]