摘要
目的探讨分子生物学检测技术对凉山州肺结核患者病原学阳性检出率的提升作用,并提出适用于凉山州的检测技术配置策略。方法采用Excel 2007软件分析2019-2020年凉山州登记治疗的肺结核患者进行痰涂片、痰培养和分子生物学检测的病原学阳性检出率;采用SPSS 21.0软件对2020年同时进行了传统检测方法与分子生物学检测的1 153例患者进行配对卡方检验和一致率检验,对2019年同时进行了传统检测方法与分子生物学检测的57例患者进行配对卡方检验,比较传统检测方法与分子生物学检测技术对结核分枝杆菌复合群的阳性检出率,检验水准α=0.05。结果凉山州2019年的肺结核患者病原学阳性检出率为21.41%(1 244/5 811),2020年为35.41%(2 321/6 554)。2019年痰涂片阳性检出率为20.20%(1 173/5 806),痰培养为41.16%(377/916),分子生物学检测为79.31%(46/58),分子生物学检测的阳性检出率高于传统检测(痰涂片和/或痰培养),差异具有统计学意义(P<0.001);2020年痰涂片阳性检出率为24.58%(1 600/6 510),痰培养为43.56%(916/2 103),分子生物学检测为58.28%(686/1 177),分子生物学检测的阳性检出率高于传统检测(痰涂片和/或痰培养),差异具有统计学意义(P<0.001)。2020年数据的一致性检验结果表明传统检测方法与分子生物学检测在阳性检出率上存在一致性(Kappa=0.271,P<0.001),但由于Kappa<0.4,说明一致性较差,符合分子生物学检测可提升阳性率的预期。结论分子生物学检测技术能极大提升病原学阳性检出率,但在诊断试剂不足的情况下,优先用于痰涂片阴性的患者,能最大化提高凉山州肺结核的病原学阳性检出率。
Objective To explore the effect of molecular biology detection technology on the positive detection rate of pulmonary tuberculosis patients in Liangshan Prefecture so as to propose a detection technology deployment strategy for Liangshan Prefecture. Methods The pathogenic positive detection rate of sputum smears, sputum culture, and molecular biology tests was calculated for pulmonary tuberculosis patients registered for treatment in Liangshan Prefecture from 2019 to 2020.Totally, 1 210 patients underwent both traditional detection methods and molecular biology tests in2019 to 2020. Chi-square tests and consistency tests were performed to compare the positive detection rate of mycobacterium tuberculosis complex between traditional detection methods and molecular biological detection techniques. Results The positive detection rate of tuberculosis was21.41% in 2019 and 35.41% in 2020 in Liangshan Prefecture. In 2019, the positive detection rate of sputum smear, sputum culture and molecular biology tests was 20.20%(1 173/5 806), 41.16%(377/916),and 79.31%(46/58),respectively. The positive detection rate of sputum smear,sputum culture and molecular biology tests in 2020 was 24.58%(1 600/6 510),43.56%(916/2 103),and58.28%(686/1 177), respectively. The positive detection rate of molecular biology test was higher than that of traditional test(sputum smear and/or sputum culture) in 2019 and 2010(P<0.05).The results of the consistency test in 2020 show that the Kappa value between the traditional detection method and the molecular biology test is 0.271(P<0.05). However,Kappa<0.4 showed that the consistency is poor. Conclusion Molecular biology detection technology can greatly increase the pathogenic positive detection rate. First priority is given to patients with negative sputum smears due to the insufficient diagnostic reagents, which can maximize the pathogenic positive detection rate of pulmonary tuberculosis in Liangshan Prefecture.
作者
冯晓英
逯嘉
王若冰
余刚
斯都巫甲
陈晓茹
阿热日阿木
的日支铁
沙马补都
王石金
FENG Xiaoying;LU Jia;WANG Ruobing;YU Gang;SIDU Wujia;CHEN Xiaoru;ARE Riamu;DERI Zhitie;SHAMA Budu;WANG Shijin(Liangshan Center for Disease Control and Prevention,Xichang 615000,Sichuan Province,China;Sichuan Center for Disease Control and Prevention,Chengdu 610041,Sichuan Province,China)
出处
《预防医学情报杂志》
CAS
2021年第7期977-981,共5页
Journal of Preventive Medicine Information
关键词
肺结核
分子生物学检测技术
病原学阳性检出率
对比研究
pulmonary tuberculosis
molecular biology detection technology
pathogenic positive detection rate
comparative study
