实时荧光PCR法检测结核杆菌的临床价值  

The Clinical Value of Real-time Fluorescent PCR in Detecting Mycobacterium Tuberculosis

作　　者：魏进武 廖俐雅 余登琼 吴朝菊 袁世梅 WEI Jinwu;LIAO Liya;YU Dengqiong;WU Chaoju;YUAN Shimei(Department of Laboratory Medicine,People's Hospital of Dianjiang County,Chongqing,408300 China)

机构地区：[1]重庆市垫江县人民医院检验科,重庆408300

出　　处：《中外医疗》2021年第20期20-23,36,共5页China & Foreign Medical Treatment

基　　金：重庆市垫江县科委重点课题(djkjxm2019jsyfysfyy 049)。

摘　　要：目的分析实时荧光PCR(QT-PCR)法检测结核杆菌的临床价值。方法方便选取2018年1月—2020年9月该院门诊和住院部接收的疑似肺结核患者作为研究对象,其中7066例使用涂片法检测,942例应用QT-PCR法进行结核分枝杆菌复合群核酸检测,561例使用固体培养法检测,其中共352名患者的样本同时进行了3种方法检测。观察涂片法、QT-PCR法、固体培养法的阳性检出率,对比涂片法和QT-PCR法检测的阳性率、特异性、灵敏度以及准确率。结果固体培养法的结核杆菌的阳性例数为205例,阳性率为36.54%。涂片法结核杆菌的阳性例数为162例,阳性检出率为2.29%;QT-PCR法结核杆菌的阳性例数为281例,阳性率为29.83%。涂片法检测的特异性为90.61%、灵敏度为69.78%、准确率为82.39%;QT-PCR法检测特异性为86.85%、灵敏度为83.45%、准确率为85.51%,QT-PCR法灵敏度与阳性率均高于涂片法,差异有统计学意义(χ^(2)=7.250、1206.103,P<0.05)。结论应用QT-PCR法对结核杆菌进行检测,具有较高的准确性,特异性、灵敏度较好,同时与固体培养法联合使用能够提高检测准确率,相较涂片法更适合应用于结核杆菌的检测。Objective To analyze the clinical value of real-time fluorescent PCR(QT-PCR)in detecting Mycobacterium tuberculosis.Methods Conveniently selected patients with suspected tuberculosis accepted by the hospital's outpatient and inpatient departments from January 2018 to September 2020 as participants in this experiment,of which 7066 cases were detected by smear method,942 cases used the QT-PCR method for the nucleic acid detection of Mycobacterium tuberculosis complex,and 561 cases used the solid culture method.Among them,samples of 352 patients were tested by three methods at the same time.Observed the positive detection rate of smear method,QT-PCR method and solid culture method,and compared the positive rate,specificity,sensitivity and accuracy rate of smear method and QT-PCR method.Results The number of positive cases of Mycobacterium tuberculosis by solid culture method was 205,and the positive rate was 36.54%.The number of positive cases of Mycobacterium tuberculosis by smear method was 162,and the positive detection rate was 2.29%;the number of positive cases of Mycobacterium tuberculosis by QT-PCR method was 281,and the positive rate was 29.83%.The specificity of the smear method was 90.61%,the sensitivity was 69.78%,and the accuracy was 82.39%.The specificity of the QT-PCR method was 86.85%,the sensitivity was 83.45%,and the accuracy was 85.51%.The sensitivity and positive rate of QT-PCR method were higher than smear method,the difference were statistically significant(χ^(2)=7.250、1206.103,P<0.05).Conclusion The QT-PCR method for the detection of Mycobacterium tuberculosis has high accuracy,specificity and sensitivity.At the same time,it can be used in combination with the solid culture method to improve the detection accuracy,which is more suitable for the detection of tuberculosis bacillus than the smear method.

关 键 词：QT-PCR法 结核杆菌检测 涂片法 固体培养法 

分 类 号：R4[医药卫生—临床医学]