摘要
目的对比多色巢式荧光定量PCR(X-pert MTB/RIF)、实时荧光RNA恒温扩增检测(SAT)和环介导恒温扩增(LAMP)诊断肺结核的价值。方法选取2017年1月-2019年6月我院87例初次复治肺结核患者作为研究对象,同时选择我院同期收治的33例非肺结核患者为对照,收集其痰液标本进行X-pert、SAT、LAMP检测并分析诊断效能,采用受试者工作特征曲线(ROC)分析三者诊断肺结核的诊断价值。结果87份初次复治肺结核患者标本中,痰涂片阳性肺结核41例,阴性肺结核46例。120份标本中,X-pert检出肺结核检出率为61.67%(74/120),SAT为70.83%(85/120),LAMP为65.83%(79/120),三者比较无统计学意义(P>0.05),以临床诊断结果为标准,SAT诊断肺结核敏感度为93.10%(81/87),明显高于X-pert敏感度82.76%(72/87)(P<0.05),与LAMP敏感度90.91%(76/87)无显著差异(P>0.05)。87例肺结核标本中,SAT检测涂阴肺结核检出率为50.57%(44/87)、LAMP为45.98%(40/87),均明显高于X-pert的31.03%(27/87)(P<0.05);以临床确诊结果为标准,SAT诊断涂阴肺结核敏感度为84.78%(39/46)、LAMP敏感度78.26%(36/46),明显高于X-pert敏感度54.35%(25/46)(P<0.05),SAT、LAMP比较无显著差异(P>0.05);X-pert、SAT和LAMP诊断涂阴肺结核的AUC分别为0.747(95%CI:0.643-0.85)、0.863(95%CI:0.779-0.947)、0.843(95%CI:0.754-0.931),三者诊断效能依次为SAT>LAMP>X-pert,比较无统计学差异(P>0.05)。结论X-pert、SAT、LAMP诊断肺结核效能较好,可用于辅助诊断肺结核疾病,SAT、LAMP对涂阴肺结核具有更好的检出率。
Objective To compare the value of polychromatic nested fluorescence quantification PCR(X-pert MTB/RIF),real-time fluorescent RNA simultaneous amplification and testing(SAT)and loop-mediated isothermal amplification(LAMP)in the diagnosis of pulmonary tuberculosis.Methods From January 2017 to June 2019,87 patients with primary retreatment of pulmonary tuberculosis in our hospital were selected as subjects.At the same time,33 patients with non-pulmonary tuberculosis admitted to our hospital were selected as controls.The sputum specimens were collected for X-pert,SAT and LAMP,and the diagnostic efficacy was analyzed,and the receiver operating characteristic curve(ROC)was used to analyze the diagnostic value of the three in the diagnosis of pulmonary tuberculosis.Results Among the 87 patients with primary retreatment of pulmonary tuberculosis,there were 41 cases of sputum smear-positive pulmonary tuberculosis and 46 cases of smear-negative pulmonary tuberculosis.Among the 120 specimens,the detection rate of pulmonary tuberculosis was 61.67%(74/120)by X-pert,70.83%(85/120)by SAT and 65.83%(79/120)by LAMP(P>0.05).Taking clinical diagnostic results as standards,the sensitivity of SAT in the diagnosis of pulmonary tuberculosis was significantly higher than that of X-pert[93.10%(81/87)vs 82.76%(72/87)](P<0.05),and there was no significant difference compared with sensitivity of LAMP with 90.91%(76/87)(P>0.05).Among the 87 tuberculosis samples,the detection rate of for smear-negative pulmonary tuberculosis was 50.57%(44/87)by SAT and 45.98%(40/87)by LAMP,which was significantly higher than that by X-pert with 31.03%(27/87)(P<0.05).Taking clinical diagnostic results as standards,the sensitivity in the diagnosis of smear-negative pulmonary tuberculosis was 84.78%(39/46)of SAT and 78.26%(36/46)of LAMP,which was significantly higher than that of X-pert with 54.35%(25/46)(P<0.05),and there was no significant difference between SAT and LAMP(P>0.05).The AUC values of X-pert,SAT and LAMP in the diagnosis of smear-negative pulmonary
出处
《现代科学仪器》
2020年第3期96-100,共5页
Modern Scientific Instruments
基金
河北省2019年度医学科学研究课题计划(20190998)。
关键词
多色巢式荧光定量PCR
实时荧光RNA恒温扩增检测
环介导恒温扩增
肺结核
诊断价值
Polychromatic nested fluorescence quantification PCR
Real-time fluorescent RNA simultaneous amplification and testing
Loop-mediated isothermal amplification
Pulmonary tuberculosis
Diagnostic value
