改良抗酸染色法联合GeneXpert法在提高疑似肺结核患者痰结核分枝杆菌检出中的应用  

Application of Modified Acid-Fast Staining Combined with GeneXpert Method in Enhancing the Detection of Mycobacterium Tuberculosis in Sputum of Suspected Pulmonary Tuberculosis Patients

作　　者：杨柳 王培兴 赖翔 张鑫 赖小菊 YANG Liu;WANG Peixing;LAI Xiang;ZHANG Xin;LAI Xiaoju(Department of Clinical Laboratory,the Fifth People's Hospital of Ganzhou,Ganzhou 341000,China)

机构地区：[1]赣州市第五人民医院检验科,江西赣州341000

出　　处：《中国医学创新》2024年第24期129-133,共5页Medical Innovation of China

基　　金：赣州市卫生健康委市级科研计划项目(2022-2-131)。

摘　　要：目的:评估改良抗酸染色法结合GeneXpert法在提高疑似肺结核患者痰中结核分枝杆菌检出率的有效性。方法:选取2022年1月—2023年1月赣州市第五人民医院收治的100例疑似肺结核患者作为研究对象。采用改良抗酸染色法和GeneXpert法检测结核分枝杆菌含量,以病理学联合临床检查诊断结果为金标准,使用受试者操作特征(ROC)曲线分析两种方法单独及联合检测的诊断效能。结果:两种方法对不同浓度结核分枝杆菌的检测结果比较,差异有统计学意义(P<0.05)。改良抗酸染色法对结核分枝杆菌阳性诊断的一致性中等(Kappa=0.500);GeneXpert法及联合检测对结核分枝杆菌阳性诊断的一致性较好(Kappa=0.822、0.950)。ROC曲线分析显示,联合检测的曲线下面积(AUC)为0.986,高于改良抗酸染色法、GeneXpert法的0.792、0.933。结论:改良抗酸染色法结合GeneXpert法能显著提高疑似肺结核患者痰中结核分枝杆菌的检出率,减少漏诊,对于提早诊断和切断肺结核的传播链具有重要意义。Objective:To evaluate the effectiveness of modified acid-fast staining combined with GeneXpert method in enhancing the detection rate of mycobacterium tuberculosis in sputum of patients with suspected pulmonary tuberculosis.Method:A total of 100 suspected pulmonary tuberculosis patients admitted to the Fifth People's Hospital of Ganzhou from January 2022 to January 2023 were selected as the study objects.Modified acid-fast staining and GeneXpert method were used to detect the content of mycobacterium tuberculosis.The diagnostic results of combined pathological and clinical examination were taken as the gold standard,and the diagnostic efficiency of the two methods was analyzed by receiver operating characteristic(ROC)curve.Result:The results of different concentration of mycobacterium tuberculosis detected by two methods were compared,and the difference was statistically significant(P<0.05).The positive diagnosis of mycobacterium tuberculosis by modified acid-fast staining was moderately consistent(Kappa=0.500).GeneXpert method and combined detection showed good consistency in positive diagnosis of mycobacterium tuberculosis(Kappa=0.822,0.950).ROC curve analysis showed that area under curve(AUC)of combined detection was 0.986,which was higher than 0.792 and 0.933 of modified acid-fast staining and GeneXpert method.Conclusion:Modified acid-fast staining combined with GeneXpert method can significantly improve the detection rate of mycobacterium tuberculosis in sputum of patients with suspected pulmonary tuberculosis,reduce missed diagnosis,and have important significance for early diagnosis and cutting off the transmission chain of tuberculosis.

关 键 词：肺结核 结核分枝杆菌 抗酸染色 

分 类 号：R446.5[医药卫生—诊断学] R521[医药卫生—临床医学]