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目的探讨转录酶主导基因 TB-RNA 扩增法、噬菌体裂解法、3D 培养法和涂片法4种实验室检测方法对结核病临床诊断的应用价值。方法用以上4种方法对临床每份送检标本同时进行同步检测。其中痰液110份、胸腔积液54份、咽拭子37份、支气管冲洗液31份、脑脊髓液13份、尿液12份、颈部淋巴液8份和其他体液(包括腹腔积液、血液、心包积液、脓性分泌物和大便等)20份以及妇科标本(包括白带、经血等)6份等共计291份。最后对上述4种方法检测结果进行评估。结果291份送检标本中,转录酶主导基因 TB-RNA 扩增法的总阳性率为37.1%,噬菌体裂解法为28.9%,3D 培养法为27.5%和涂片法为10.3%;4种方法检测的敏感度、特异度分别依次为:54.3%和100%、41.7%和98.9%、31.7%和83.5%以及14.6%和98.9%。结论转录酶主导基因 TB-RNA扩增法对结核病临床诊断有较高的应用价值;涂片法阳性率低但其成本低廉且能在实验室中广泛开展;噬菌体裂解法的阳性率略高于培养法;而培养法阳性率远低于转录酶主导基因 TB-RNA 扩增法和略低于噬菌体裂解法,且需时较长,但培养出的分枝杆菌可做药物敏感性试验和菌型鉴定。
OBJECTIVE To investigate the clinical value of transcriptase-induced gene TB-RNA amplification, phage lysis, 3D culture and smear methods in the clinical diagnosis of tuberculosis. Methods The above four kinds of methods of clinical specimens simultaneously for each test simultaneously detected. Among them sputum 110, pleural effusion 54, throat swab 37, bronchial fluid 31, cerebrospinal fluid 13, urine 12, neck lymph 8 and other body fluids (including ascites, Blood, pericardial effusion, purulent secretions and stool, etc.) and gynecological specimens (including leucorrhea, menstrual blood, etc.) 6 and a total of 291 copies. Finally, the above four methods test results were evaluated. Results The total positive rate of TB-RNA amplification was 37.1% in the 291 samples tested, 28.9% in the phage lysis method, 27.5% in the 3D culture method and 10.3% in the smear method. Four methods Sensitivity and specificity of detection were 54.3% and 100%, 41.7% and 98.9%, 31.7% and 83.5% and 14.6% and 98.9%, respectively. Conclusion The transcriptase-dominant gene TB-RNA amplification method has a high value in clinical diagnosis of tuberculosis. The positive rate of smear method is low, but its cost is low and can be widely used in the laboratory. The positive rate of phage lysis method is slightly higher than Culture method; and culture positive rate is much lower than the transcriptase leading gene TB-RNA amplification method and slightly lower than the phage lysis method, and take a long time, but the cultured mycobacterium can do drug sensitivity test and bacteria Type identification.