复苏因子薄层琼脂快速培养法诊断结核性胸膜炎的应用研究

目的 建立胸腔积液结核分枝杆菌(Mycobacterium tuberculosis,M.tb)复苏因子薄层琼脂(Rpfs-TLA)快速培养法并评估其临床应用价值。方法 收集2016年7月至2018年11月北京胸科医院103例结核性胸膜炎和34例其他胸膜疾病患者的胸腔积液，经过离心、消化处理后进行M.tb复苏因子薄层琼脂和普通薄层琼脂培养，比较Rpfs-TLA与普通TLA培养M.tb的阳性率、平均报阳时间、菌落形成单位数的组间差异。结果 胸腔积液Rpfs-TLA培养组和普通TLA对照组M.tb的阳性率分别为43.7%和29.1%,差异有统计学意义(χ²=54.56,P<0.001)。Rpfs-TLA培养显微镜下微菌落与肉眼可视菌落平均报告时间为11.87 d和18.13 d,差异有统计学意义(t=31.82,P<0.001)。Rpfs-TLA与普通TLA培养显微镜下微菌落的平均报告时间为11.87 d和20.60 d,差异有统计学意义(t=16.62,P<0.001)。Rpfs-TLA诊断结核性胸膜炎的灵敏度为43.7%,特异度为100%,准确度...

Application value of resuscitation promoting factor-based thin layer agar culture in the diagnosis of tuberculous pleurisy

This study established a rapid resuscitation promoting factor-based thin layer agar (Rpf-TLA) culture method and evaluated its potential for clinical application. From July 2016 to November 2018, 103 patients with tuberculous pleurisy and 34 patients with non-pleural tuberculosis (TB) (control group) were enrolled at the Beijing Chest Hospital. After centrifugation and decontamination, the pleural effusions of patients was collected and cultured with Rpf-TLA for detection of Mycobacterium tuberculosis (M.tb). The positivity rate, average reporting time and mean numbers of colony forming units were compared between groups. The positivity rate of M.tb was 43.7% in the Rpf-TLA culture group and 29.1% in the TLA control group, and the difference was statistically significant (χ²=54.56, P<0.001). The average reporting time of Rpf-TLA and TLA culture was 11.87 days and 20.60 days, on the basis of microscopic observation of microcolonies, and the difference was statistically significant (t=16.62, P<0.001). The mean number of colony forming units was 75.23×10³ by Rpf-TLA, which was significantly greater than that by TLA (28.17×10³; t=4.72, P<0.001). The sensitivity, specificity and accuracy of Rpf-TLA were 43.7%, 100% and 57.7% in the diagnosis of tuberculous pleurisy. Thus, Rpf-TLA is an accurate, rapid, inexpensive and easy culture method for the diagnosis of tuberculous pleurisy.