肺结核临床诊断中应用LAMP技术的价值分析  

Value Analysis of LAMP Technology in Clinical Diagnosis of Pulmonary Tuberculosis

作　　者：宋婷阁[1] 杨鹏 胡菊[1] 张彬[1] 槐聪颖 闫瑾 张沪 郝杰 SONG Ting-ge;YANG Peng;HU Ju;ZHANG Bin;HUAI Cong-ying;YAN Jin;ZHANG Hu;HAO Jie(Department of clinical laboratory,Baoding No.2 Central Hospital,Baoding,Hebei,072750,China)

机构地区：[1]保定市第二中心医院检验科,河北保定072750

出　　处：《现代生物医学进展》2024年第13期2527-2531,共5页Progress in Modern Biomedicine

基　　金：2018年河北省省级科技计划项目(182777239);2023年保定市科技计划项目(2341ZF043)。

摘　　要：目的:探讨环介导等温扩增技术(LAMP)在肺结核诊断中的潜在应用。方法:回顾性分析305例2020年6月~2023年6月保定市第二中心医院收治的疑似肺结核患者的临床资料,以病理结果为依据,纳入非肺结核病组(123例)和肺结核组(182例)。分析不同性状痰标本中,应用改良罗氏培养法、涂片抗酸染色法、LAMP检测结核分枝杆菌的阳性情况、诊断结果以及价值。结果:较涂片抗酸染色法、改良罗氏培养法,LAMP各种样本性状的检查阳性率均相对较高,其中相较于其他样本性状,各项检查对样本性状为干酪痰的检查阳性率均相对较高。涂片抗酸染色法检查结果显示,阳性80例,阴性119例,误诊4例,漏诊102例;改良罗氏培养法检查结果显示,阳性104例,阴性120例,误诊3例,漏诊78例;LAMP检查结果显示,阳性135例,阴性121例,误诊2例,漏诊47例。与涂片抗酸染色法、改良罗氏培养法检查进行比较,LAMP检查诊断结核分枝杆菌的敏感度、阴性预测值、准确度及曲线下面积(AUC)值均相对较高,其中涂片抗酸染色法敏感度、准确度及AUC值均低于改良罗氏培养法(P<0.05)。结论:LAMP技术有利于鉴别各种性状样本的结核分枝杆菌,并且对痰液样本中的结核分支杆菌具有较高的检测诊断敏感度、阴性预测值和准确度,对肺结核的诊断价值更高。Objective: The aim of this study is to investigate the potential application of loop-mediated isothermal amplification technology(LAMP) in the diagnosis of pulmonary tuberculosis. Methods: The clinical data of 305 patients with suspected tuberculosis admitted to Baoding Second Central Hospital from June 2020 to June 2023 were retrospectively analyzed. Based on the pathological results, the non-tuberculosis group(123 cases) and tuberculosis group(182 cases) were included. The sputum samples with different traits,using modified Roche culture method, smear acid stain method and LAMP detection of Mycobacterium tuberculosis. Results: Compared with the smear acid-fast staining method and the improved Roche culture method, the positive rate of LAMP samples was relatively high,and the positive rate of LAMP samples with cheese sputum was relatively high compared with other samples. The results of acid-fast staining showed that 80 cases were positive, 119 cases were negative, 4 cases were misdiagnosed and 102 cases were missed. The results of modified Roche culture showed that 104 cases were positive, 120 cases were negative, 3 cases were misdiagnosed and 78 cases were missed. LAMP results showed that 135 cases were positive, 121 cases were negative, 2 cases were misdiagnosed and 47 cases were missed. Compared with smear acid staining method and modified Roche culture method, the sensitivity, negative predictive value, accuracy and area under the curve(AUC) value of LAMP examination were relatively high, in which the sensitivity, accuracy and AUC value of smear acid staining method were lower than those of modified Roche culture method(P<0.05). Conclusion: LAMP technique was beneficial to the identification of Mycobacterium tuberculosis in various trait samples, and had high diagnostic sensitivity, negative predictive value and accuracy for Mycobacterium tuberculosis in sputum samples, which had higher diagnostic value for pulmonary tuberculosis.

关 键 词：环介导等温扩增技术 肺结核 改良罗氏培养法 涂片抗酸染色法 诊断价值 

分 类 号：R521[医药卫生—内科学]