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目的探讨痰样结核杆菌抗原85B m RNA检测在结核疗效评价中应用。方法比较痰涂片抗酸染色、MTB-IS6110 DNA、改良罗氏培养和MTB-抗原85B m RNA在检测治疗0、2、4、8、12周的结核患者痰液结核杆菌阳性率。结果治疗0周、2周和12周时四种方法检测差异无统计学意义;治疗4周、8周时四种方法阳性率总体差异有统计学意义(χ2=23.167,P<0.05;χ2=18.196,P<0.05),其中MTB-IS6110 DNA和改良罗氏培养差异有统计学意义(χ2=17.03,P<0.05;χ2=14.428,P<0.05);MTB-IS6110 DNA和MTB-抗原85B m RNA之间差异无统计学意义(χ2=2.865,P>0.05;χ2=3.262,P>0.05)。治疗4周时改良罗氏培养和MTB-抗原85B m RNA差异没有统计学意义(χ2=6.377,P>0.05),而治疗8周时差异有统计学意义(χ2=4.97,P<0.05)。结论 MTB-IS6110 DNA检测灵敏度最高,可作为初筛,MTB-抗原85B m RNA real-RT-PCR和改良罗氏培养两者一致性较好,且灵敏度和特异性更高,可作为结核病人治疗监测。
Objective To investigate the application of sputum-like Mycobacterium tuberculosis antigen 85B m RNA in evaluating the curative effect of tuberculosis. Methods Sputum smear antitumor staining, MTB-IS6110 DNA, modified Roche culture and MTB-antigen 85B m RNA were used to detect the positive rate of Mycobacterium tuberculosis in patients with tuberculosis at 0, 2, 4, 8 and 12 weeks. Results There was no significant difference between the four methods in the treatment of 0, 2 and 12 weeks of treatment. There was a significant difference in the positive rates of the four methods between the 4 and 8 weeks (χ2 = 23.167, P <0.05; χ2 = 1861.6, P <0.05). MTB-IS6110 DNA and modified Roche culture showed statistically significant difference (χ2 = 17.03, P <0.05; The difference was not statistically significant (χ2 = 2.865, P> 0.05; χ2 = 3.262, P> 0.05). There was no significant difference between the modified Roche culture and the MTB-antigen 85B m RNA after 4 weeks of treatment (χ2 = 6.377, P> 0.05), but the difference was statistically significant at the 8th week (χ2 = 4.97, P <0.05). Conclusion MTB-IS6110 DNA has the highest sensitivity and can be used as primary screening. MTB-antigen 85B m RNA real-RT-PCR and modified Roche culture have better consistency and sensitivity and specificity, which can be used as a monitor for the treatment of TB patients .