辽宁省2016—2022年结核病实验室检测结果分析  

Analysis on the technical results of tuberculosis laboratory testing in Liaoning Province from 2016 to 2022

作　　者：梁爽[1] 蒋轶文 杨桂玲[1] 张琪 唐诗邈[1] 曹宏伟[1] 戚巍[1] LIANG Shuang;JIANG Yiwen;YANG Guiling;ZHANG Qi;TANG Shimiao;CAO Hongwei;QI Wei(Liaoning Provincial Center for Disease Control and Prevention,Shenyang,Liaoning 110172,China)

机构地区：[1]辽宁省疾病预防控制中心,辽宁沈阳110172

出　　处：《中国热带医学》2023年第9期906-910,共5页China Tropical Medicine

基　　金：国家科技重大专项课题项目(No.2018ZX10103001)。

摘　　要：目的 了解辽宁省2016—2022年结核病实验室检测技术应用情况,为提高全省肺结核病原检出率提供科学依据。方法 从《中国疾病预防控制信息系统》子系统中《结核病信息管理系统》中收集辽宁省2016—2022年登记肺结核患者病案信息,对采用痰涂片、痰培养、分子生物学检测情况进行统计分析。结果 2016—2022年辽宁省累计登记肺结核患者152 778例,痰涂片检测率为98.03%(149 775/152 778),痰培养检测率为20.72%(31 661/152 778),分子生物学检测率为20.21%(30 737/152 778),2018—2022年分子生物学检测率呈上升趋势(χ^(2)_(趋势)=7 104.466,P<0.01),2016—2021年痰培养检测率呈上升趋势,差异有统计学意义(χ^(2)_(趋势)=3 068.701,P<0.01)。痰涂片检测率整体呈下降趋势(χ^(2)_(趋势)=689.913,P<0.01)。痰涂片阳性或阴性经痰培养和分子生物学检测差异有统计学意义(McNemar检验,P<0.01),痰培养阳性或阴性经痰涂片和分子生物学检测差异有统计学意义(McNemar检验,P<0.01)。分子生物学阳性或阴性经痰涂片和痰培养检测差异有统计学意义(McNemar检验,P<0.01)病原学阳性率从2016年26.27%上升到2022年51.55%,呈逐年上升趋势(χ^(2)_(趋势)=5 262.863,P<0.01),各年度差异有统计学意义(χ^(2)=5 686.935,P<0.01)。在病原学阳性肺结核患者中,痰涂片阳性构成比从94.32%下降到52.36%,呈下降趋势(χ^(2)_(趋势)=5 010.104,P<0.01);仅培阳构成比从2016的5.68%上升到2022年的12.83%,呈上升趋势(χ^(2)_(趋势)=122.501,P<0.01),从2018年开始开展分子生物学检测,分子生物学阳性构成比从11.51%上升到34.81%,呈上升趋势(χ^(2)_(趋势)=1 969.326,P<0.01)。市级医院分子生物学检测中的阳性患者数占病原学阳性患者的18.69%(8 386/44 778),县级医院分子生物学检测中的阳性患者数占病原学阳性患者的13.61%(2 439/17 924),差异有统计学意义(χ^(2)=231.594,P<0.01))。结论 辽宁省结核病实验室开展�Objective To evaluate the application of TB laboratory detection technology in Liaoning Province from 2016 to 2022,and to provide scientific basis for further improving the detection rate of Mycobacterium tuberculosis in the province.Methods The medical records of registered tuberculosis patients in Liaoning Province from 2016 to 2022 were collected from the"Tuberculosis Information Management System"in the"China Disease Prevention and Control Information System"subsystem.Statistical analysis was performed for sputum coating,sputum culture,and molecular biology testing.Results From 2016 to 2022,a total of 152778 patients with pulmonary tuberculosis were registered in Liaoning Province.The detection rate of sputum smear microscopy was 98.03%(149775/152778),the detection rate of sputum culture was 20.72%(31661/152778),and the detection rate of molecular biology testing was 20.21%(30737/152778).From 2018 to 2022,the rate of molecular biological detection showed an increasing trend(χ^(2)_(trend)=7104.466,P<0.01),while from 2016 to 2021,the detection rate of sputum culture showed an increasing trend,with statistical significance(χ^(2)_(trend)=3,068.701,P<0.01).The sputum smear detection rate showed a downward trend(χ^(2)_(trend)=689.913,P<0.01)..There were significant differences in the results of sputum smear microscopy,sputum culture,and molecular biology testing,as confirmed by the McNemar test(P<0.01).The positive rate of pathogenic academics increased from 26.27%in 2016 to 51.55%in 2022,showing a yearly upward trend(χ^(2)_(trend)=5262.863,P<0.01),with significant differences between each year(χ^(2)=5686.935,P<0.01).Among pulmonary tuberculosis patients with positive pathogenic microorganisms,the proportion of sputum smear-positive cases decreased from 94.32%to 52.36%,showing a downward trend(χ^(2)_(trend)=5010.104,P<0.01).The proportion of culture-positive cases increased from 5.68%in 2016 to 12.83%in 2022,showing an upward trend(χ^(2)_(trend)=122.501,P<0.01).In Liaoning Province,molecular biology testing

关 键 词：肺结核 病原学 分子生物学检测 痰涂片 痰培养 

分 类 号：R521.1[医药卫生—内科学]