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目的探讨改良抗酸染色法在盆腔积液中检测结核分枝杆菌对于盆腔结核的诊断价值。方法建立改良抗酸染色法,对58例已确诊为盆腔结核病人及58例盆腔肿瘤病人(对照组)的盆腔积液分别利用改良抗酸染色法、离心涂片法、荧光定量PCR法进行检测,比较3种方法的检测灵敏度及特异度。结果改良抗酸染色法、离心涂片法、荧光定量PCR法的灵敏度分别为34.48%(20/58)、1.72%(1/58)和39.66%(23/58)。改良抗酸染色法与离心涂片法灵敏度差异有统计学意义,改良抗酸染色法较高(配对χ~2=19.00,P<0.001);改良抗酸染色法和荧光定量PCR法差异无统计学意义(配对χ~2=3.00,P>0.05);离心涂片法和荧光定量PCR法差异有统计学意义,荧光定量PCR法较高(配对χ~2=22.00,P<0.001)。3种方法特异度分别为100.00%、100.00%和95.08%,差异无统计学意义(配对χ~2=3.00,P>0.05)。结论盆腔积液采用改良抗酸染色法进行结核分枝杆菌检测灵敏度高,特异度好,具有较高的临床应用价值。
Objective To investigate the diagnostic value of modified acid-fast staining in detection of Mycobacterium tuberculosis in pelvic fluid for pelvic tuberculosis. Methods To establish a modified acid-fast staining method, 58 cases of pelvic tuberculosis patients and 58 cases of pelvic tumor patients (control group) were treated with modified acid-fast staining, centrifugal smear and fluorescence quantitative PCR , Comparing the detection sensitivity and specificity of the three methods. Results The sensitivity of modified acid-fast staining method, centrifugal smear method and fluorescence quantitative PCR method were 34.48% (20/58), 1.72% (1/58) and 39.66% (23/58) respectively. There was significant difference between the modified acid-fast staining method and the centrifugal smear method, the improved acid-fast staining method was higher (paired χ ~ 2 = 19.00, P <0.001); there was no statistical difference between the modified acid-fast staining method and the real- (Χ ~ 2 = 3.00, P> 0.05). There was significant difference between centrifugation smear method and real-time fluorescence quantitative PCR method, and the fluorescence quantitative PCR method was higher (paired χ ~ 2 = 22.00, P <0.001). The specificity of the three methods were 100.00%, 100.00% and 95.08%, respectively, with no significant difference (paired χ ~ 2 = 3.00, P> 0.05). Conclusion Pelvic fluid using modified acid-fast staining for detection of Mycobacterium tuberculosis has high sensitivity and good specificity, and has high clinical value.