摘要
目的研究实时荧光定量聚合酶链式反应(qRT-PCR)与玻璃珠磨菌法联合用于不同结核标本检测中的价值。方法以回顾性分析为法,收集并分析2021年1月至2022年6月在上海交通大学医学院附属仁济医院住院与门诊诊治的疑似结核病患者1200份不同临床标本的qRT-PCR测定结果,其中血液样本469份,胸腔积液标本322份,心包积液标本16份,尿液标本25份,气管(支气管)肺泡灌洗液标本8份,腹腔积液标本34份,脑脊液标本143份,脓液标本31份,痰液标本152份;同时,对41份痰液标本予以玻璃珠振荡磨菌前后qRT-PCR定量检测效果分析。结果1200份不同结核标本的总检测阳性率为15.83%(190/1200),其中检出率最高的为气管(支气管)肺泡灌洗液标本,占比为37.50%(3/8),且门诊患者阳性率最高,占比为40.00%(2/5);脓液标本检出率第二,占比为35.48%(11/31),且住院患者阳性率最高,占比为38.46%(10/26);痰液标本检出率第三,占比为30.26%(46/152)。41份痰液标本经玻璃珠磨菌处理5 min之后,qRT-PCR检测核酸浓度明显高于处理前,差异有统计学意义(P<0.05);其中,14份痰液标本提升了菌株数量级,且11份含菌量为10^(2)拷贝/mL痰液标本于振荡研磨处理之后,7份痰液标本提升至了10^(3)拷贝/mL菌量数量级,磨菌处理后阳性检出率明显高于磨菌处理前,差异有统计学意义(P<0.05)。结论气管(支气管)肺泡灌洗液标本、脓液标本、痰液标本检测中qRT-PCR的检出率较高,而qRT-PCR在其他结核标本检测中的检出率较低,qRT-PCR联合玻璃珠磨菌法检测可有效提升临床结核标本阳性检出率。
Objective To study the value of real-time quantitative fluorescent polymerase chain reaction(qRT-PCR)combined with glass beads method in the detection of different tuberculosis specimens.Methods By retrospective analysis,qRT-PCR results of 1200 different clinical specimens of suspected tuberculosis patients treated in inpatients and outpatients of Renji Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from January 2021 to June 2022 were collected and analyzed,including 469 blood samples,322 pleural effusion samples,16 pericardial effusion samples,and 25 urine samples.Trachea(bronchial)alveolar lavage fluid samples 8,abdominal fluid samples 34,cerebrospinal fluid samples 143,pus samples 31,sputum samples 152;At the same time,41 sputum samples clinically diagnosed as pulmonary tuberculosis were selected by establishing the pseudo-random function method,and the quantitative detection effect of qRT-PCR before and after glass bead oscillating grinding bacteria was analyzed.Results The total positive rate of 1200 tuberculosis specimens was 15.83%(190/1200),among which the highest positive rate was 37.50%(3/8)in trachea(bronchial)alveolar lavage fluid specimen,and the highest positive rate was 40.00%(2/5)in outpatients.The positive rate of pus specimen was the second highest in 35.48%(11/31),and the highest in inpatients was 38.46%(10/26).The detection rate of sputum specimen was the third,the proportion was 30.26%(46/152).The concentration of nucleic acid detected by qRT-PCR was significantly higher than that before treatment,the difference was statistically significant(P<0.05).Among them,14 sputum samples were increased by the order of strain,and 11 sputum samples with 10^(2) copies/mL bacteria content were increased to the order of 10^(3) copies/mL bacteria content after the oscillatory grinding treatment,and 7 sputum samples were increased to the order of 10^(3) copies/mL bacteria content.The positive detection rate after the grinding treatment was significantly higher than that before the gri
作者
张鑫
周辰刚
ZHANG Xin;ZHOU Chen-gang(Department of Clinical Laboratory,Renji Hospital Affiliated to Shanghai Jiao Tong University School of Medicine,Shanghai 200012,China)
出处
《临床和实验医学杂志》
2024年第6期637-641,共5页
Journal of Clinical and Experimental Medicine
基金
上海市自然科学基金项目(编号:2021FK28)。
关键词
实时荧光定量聚合酶链式反应
玻璃珠磨菌法
结核分枝杆菌
检测
Real-time fluorescence quantitative polymerase chain reaction
Glass bead method
Tuberculosis
Mycobacterium
Detection
