复苏因子薄层琼脂快速培养法诊断结核性胸膜炎的应用研究  

Application value of resuscitation promoting factor-based thin layer agar culture in the diagnosis of tuberculous pleurisy

作　　者：邢爱英[1] 杜凤娇[1] 李自慧[1] 杜博平 孙琦[1] 贾红彦[1] 魏荣荣[1] 潘丽萍[1] 刘忠泉[1] XING Ai-ying;DU Feng-jiao;LI Zi-hui;DU Bo-ping;SUN Qi;JIA Hong-yan;WEI Rong-rong;PAN Li-ping;LIU Zhong-quan(Beijing Chest Hospital,Capital Medical University,Beijing Key Laboratory of Drug Resistance Tuberculosis Research,Beijing Tuberculosis and Thoracic Tumor Research Institute,Beijing 101149,China)

机构地区：[1]首都医科大学附属北京胸科医院/北京市结核病胸部肿瘤研究所,耐药结核病研究北京市重点实验室,北京101149

出　　处：《中国人兽共患病学报》2022年第9期802-806,共5页Chinese Journal of Zoonoses

基　　金：国家自然科学基金(No.81902024、No.82070012);北京市自然科学基金(No.7212012);首都卫生发展科研专项(No.2020-2-2162);北京市属医院科研培育计划(No.pX2019059)联合资助。

摘　　要：目的建立胸腔积液结核分枝杆菌(Mycobacterium tuberculosis,M.tb)复苏因子薄层琼脂(Rpfs-TLA)快速培养法并评估其临床应用价值。方法收集2016年7月至2018年11月北京胸科医院103例结核性胸膜炎和34例其他胸膜疾病患者的胸腔积液,经过离心、消化处理后进行M.tb复苏因子薄层琼脂和普通薄层琼脂培养,比较Rpfs-TLA与普通TLA培养M.tb的阳性率、平均报阳时间、菌落形成单位数的组间差异。结果胸腔积液Rpfs-TLA培养组和普通TLA对照组M.tb的阳性率分别为43.7%和29.1%,差异有统计学意义(χ^ (2)=54.56,P<0.001)。Rpfs-TLA培养显微镜下微菌落与肉眼可视菌落平均报告时间为11.87 d和18.13 d,差异有统计学意义(t=31.82,P<0.001)。Rpfs-TLA与普通TLA培养显微镜下微菌落的平均报告时间为11.87 d和20.60 d,差异有统计学意义(t=16.62,P<0.001)。Rpfs-TLA诊断结核性胸膜炎的灵敏度为43.7%,特异度为100%,准确度为57.7%。结论Rpfs-TLA是一种准确、快速、廉价且易于培养的方法,可为结核性胸膜炎诊断提供帮助。This study established a rapid resuscitation promoting factor-based thin layer agar(Rpf-TLA)culture method and evaluated its potential for clinical application.From July 2016 to November 2018,103 patients with tuberculous pleurisy and 34 patients with non-pleural tuberculosis(TB)(control group)were enrolled at the Beijing Chest Hospital.After centrifugation and decontamination,the pleural effusions of patients was collected and cultured with Rpf-TLA for detection of Mycobacterium tuberculosis(M.tb).The positivity rate,average reporting time and mean numbers of colony forming units were compared between groups.The positivity rate of M.tb was 43.7%in the Rpf-TLA culture group and 29.1%in the TLA control group,and the difference was statistically significant(χ^ (2)=54.56,P<0.001).The average reporting time of Rpf-TLA and TLA culture was 11.87 days and 20.60 days,on the basis of mi croscopic observation of microcolonies,and the difference was statistically significant(t=16.62,P<0.001).The mean number of colony forming units was 75.23×103 by Rpf-TLA,which was significantly greater than that by TLA(28.17×103;t=4.72,P<0.001).The sensitivity,specificity and accuracy of Rpf-TLA were 43.7%,100%and 57.7%in the diagnosis of tuberculous pleurisy.Thus,Rpf-TLA is an accurate,rapid,inexpensive and easy culture method for the diagnosis of tuberculous pleurisy.

关 键 词：结核分枝杆菌 复苏促进因子 薄层琼脂 胸膜积液 培养 

分 类 号：R378.91[医药卫生—病原生物学]