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目的:探讨联合检测方案快速诊断结核病及耐多药结核病临床价值。方法:研究对象选取我院2010年8月-2014年12月收治结核患者共590例,以BACTEC MGIT-960作为诊断金标准,分析采用浓缩涂片+TB-DNA+SAT TB-RNA快速法与HAIN联合检测方案用于结核及耐多药结核诊断敏感性和特异性。结果:入选结核病患者采用BACTEC MGIT-960和快速法联合检测方案检出率分别为46.95%(277/590),47.97%(283/590);两种检测方法结核病检出率比较差异无统计学意义(P>0.05);以BACTEC MGIT-960作为诊断金标准,快速法联合检测方案用于结核诊断敏感性和特异性分别为97.83%(271/277),96.17%(301/313);入选结核病患者采用BACTEC MGIT-960和HAIN联合检测方案检出率分别为8.63%(24/278),7.91%(22/278);两种检测方法耐多药结核病检出率比较差异无统计学意义(P>0.05);以BACTEC MGIT-960作为诊断金标准,HAIN联合检测方案用于耐多药结核诊断敏感性和特异性分别为91.67%(22/24),99.22%(254/256)。结论:联合检测方案快速诊断结核病及耐多药结核病具有较高敏感性及特异性,可在临床加以推广应用。
Objective: To explore the clinical value of rapid detection of tuberculosis and multidrug-resistant tuberculosis by the combined detection protocol. Methods: The subjects selected from our hospital from August 2010 to December 2014 a total of 590 cases of tuberculosis patients admitted to BACTEC MGIT-960 as the gold standard for diagnosis, the use of concentrated smear + TB-DNA + SAT TB-RNA rapid method and HAIN joint detection program for tuberculosis and MDR-TB diagnostic sensitivity and specificity. Results: The detection rates of BACTEC MGIT-960 and rapid test were 46.95% (277/590) and 47.97% (283/590) respectively. There was no significant difference in the detection rate of tuberculosis between the two methods (P> 0.05). The sensitivity and specificity of BACTEC MGIT-960 as gold standard for diagnosis and tuberculosis diagnosis were 97.83% (271/277) and 96.17% (301/313), respectively. The detection rates of tuberculosis patients using BACTEC MGIT-960 and HAIN were 8.63% (24/278) and 7.91% (22/278), respectively. There was no significant difference in the detection rate of MDR-TB between the two methods (P> 0.05). Using BACTEC MGIT-960 as the gold standard for diagnosis, the sensitivity and specificity of HAIN combined detection for the diagnosis of MDR-TB were 91.67% (22/24) and 99.22% (254/256), respectively. Conclusion: The rapid detection of tuberculosis and multidrug-resistant tuberculosis (TB) by the combined test is highly sensitive and specific and can be widely applied in clinic.