摘要
目的评估改良萋-尼染色液染色镜检分枝杆菌在痰涂片中的检测效能。方法2014年6月至2014年9月于北京结核病控制研究所和广州市胸科医院顺序纳入就诊，按照临床症状和体征、临床相关检测判断为可疑肺结核病患者835例痰标本共1024份（北京结核病控制研究所435例505份痰标本，广州市胸科医院400例519份痰标本），分别涂片进行传统萋-尼染色法（三步法）镜检、改良萋一尼染色法（二步法）镜检和简单法固体罗氏培养（L-J法），比较两种染色方法结果的一致性，并以L-J法结果为金标准，比较两种染色法阳性检出率的差异、诊断的准确性及可操作性。结果改良萋一尼染色法和传统萋一尼染色法的阳性检出率分别为11．62％（119／1024）和11．91％（122／1024），差异无统计学意义（X^2=3．18，P〉0．05），两法有良好的一致性（Kappa〉0．75）；以L-J法结果为金标准，改良萋-尼染色和传统萋-尼法检测结核分枝杆菌的敏感度和特异度分别为52．94％（90／170）和56．47％（96／170）；97．66%（834／854）和96．96oA（828／854）。以上两种方法的ROC曲线下面积分别是0．76和0．77，有中等的诊断价值。结论改良萋-尼染色法在检出分枝杆菌方面比传统萋-尼染色法有较好的敏感度与特异度，对于诊断肺结核有较好的诊断价值。
Objective To assess the efficiency of improved Ziehl-Neelsen （ZN） acid-fast staining method to detect mycobacteria in sputum. Methods A total of 1024 sputum specimens of 835 suspected pulmonary tuberculosis patients from Beijing Institute of TB Control TB control（505 sputum specimens of 435 patients） and Guangzhou Chest hospital（519 sputum specimens of 400 patients） from June 2014 to September 2014 were detected by conventional ZN acid-fast staining method （3 step method）, improved ZN acid-fast staining method （2 step method） and Lownstein-Jenson （L-J） culture respectively. Setting the L-J culture as golden standard, the positive rate, diag- nostic accuracy and operability were compared between two staining methods. Results The positive rate of im- proved ZN acid-fast staining method and conventional ZN acid-fast staining method was 11.62% （119/1024） and 11.91% （122/1024）, respectively. No difference was observed between two group （Z2 =3.18,P^0. 05）, and they have good consistency （Kappa ~0.75）. The sensitivity and specificity were 52.94% （90/170） and 97.66% （834/854） for improved ZN method, and 56.47% （96/170） and 96.96% （828/854） for conventional method, re- spectively. The areas under the ROC curve of these two methods were 0.76 and 0.77, respectively, demonstrating that both of them had medium diagnostic value. Conclusion Our results show that improved ZN acid-fast staining method has better sensitivity and specificity for detecting mycobacteria, which can provide favorable diagnostic value in the diagnosis of pulmonary tuberculosis.
出处
《中国防痨杂志》
CAS
2015年第6期603-606,共4页
Chinese Journal of Antituberculosis
基金
广州市科技计划项目（201508020007）
关键词
结核
肺/诊断
结核分枝杆菌
染色与标记
显微镜检查
敏感度与特异度
Tuberculosis, pulmonary/diagnosis
Mycobacterium tuberculosis
Staining and labeling
Microscopy
Sensitivity and specificity
