摘要
目的评价实时荧光核酸恒温扩增技术(SAT-TB)在肺结核诊断中的价值。方法纳入1121例非相同患者痰标本,其中26例为非结核分枝杆菌。570例肺结核为观察组,525例其他肺部疾病患者为对照组。对治疗前的痰标本分别进行抗酸杆菌涂片、培养及鉴定和SAT法检测。阳性检出率的比较使用卡方检验。结果临床诊断肺结核570例,痰培养结核菌阳性率46.5%(265/570),SAT法检测阳性率46.7%(266/570),痰涂片阳性率34.4%(196/570),SAT与涂片法阳性率的差异有统计学意义(χ2=17.83,P<0.01)。在涂阴肺结核中,SAT阳性率达19.5%。以培养阳性作为金标准,SAT法诊断结核病的灵敏度为89.4%,特异度96.3%,阳性似然比为24.2,阴性似然比为0.11,一致率是94.6%,阳性预测值是88.4%,阴性预测值为96.6%。在非结核分枝杆菌肺病中SAT检测阳性率为零。结论 SAT-TB法在肺结核的早期诊断中是一种快速、准确、敏感的方法,值得推广。
Objective To evaluate the diagnostic value of simultaneous amplification and testing （SAT-TB） in patients with pulmonary tuberculosis. Methods A total of 1121 patients′ sputum samples were cultured or given sputum smear and SAT-TB assay, including 26 cases of non-tuberculous mycobacteria （NTM）, 570 cases of pulmo-nary tuberculosis, and 525 cases infected with other pulmonary diseases. The positive rates were analyzed by chi-square test. Results The positive rate were 46. 7% （266 / 570） by SAT assay, followed by sputum culture method （46. 5% , 265 / 570）, and sputum smear （34. 4% , 196 / 570） in the clinical diagnosis tuberculosis. The difference between SAT assay and smear was significant （χ^2 = 17. 83, P 〈 0. 01）. The positive rate of SAT was 19. 5% for smear negative patients. With the result of culture as the golden standard, the sensitivity and specificity of SAT-TB were 89. 4% and 96. 3% , the positive and negative likelihood ratio were 24. 2 and 0. 11, and the positive predictive value and negative value were 88. 4% and 96. 6% respectively. No positive samples was detected by SAT-assay in the NTM cases. Conclusion SAT assay is a rapid, sensitive and specific method for the early diagnosis of patients with pulmonary tuberculosis.
出处
《临床肺科杂志》
2015年第8期1487-1489,共3页
Journal of Clinical Pulmonary Medicine
关键词
实时荧光核酸恒温扩增
结核/肺
结核分枝杆菌
痰涂片
痰培养
simultaneous amplification and testing
tuberculosis/pulmonary
Mycobacterium tuberculosis
sputum smear
sputum culture
