PCR-荧光探针杂交技术诊断肺结核的价值及卫生经济学评价

目的　探讨PCR -荧光双标记探针杂交定量结核杆菌技术对肺结核的诊断价值并进行卫生经济学评价。方法 对 2 0 0 2年 5月至 2 0 0 2年 11月收治的 30 1例患者进行回顾性研究 ,将痰PCR-荧光探针杂交法与荧光抗酸染色涂片法进行比较 ,以综合临床资料最后确诊为诊断标准 ,计算两种方法的诊断效率及进行成本 -效果分析。结果 痰PCR -荧光探针法诊断肺结核的灵敏度为5 1.9% ,涂片法 1次、3次、6次的灵敏度分别为 4 9.2 %、5 7.4 %、6 1.2 % ,经统计学分析 ,两种方法的检出率比较差异无显著性 (P>0 .0 5 ) ,进行成本 -效果分析 ,每检出 1例肺结核行 1次痰PCR -荧光探针法患者要花费 2 5 3.4 7元 ,行 1次涂片法要花费 5 0 .17元。结论 PCR -荧光探针杂交法与涂片法比较同样具有快速、有效等优点 ,但经济效率低于荧光涂片法 ,目前尚不能取代后者在诊断结核病中的传统地位。

Diagnostic value and health economic evaluation of fluorogenic hybridization assay in pulmonary tuberculosis

Objective To probe the diagnostic value and health economic evaluation of PCR-fluorogenic hybridization assay in pulmonary tuberculosis.Methods To analysis and compare the results of sputum PCR-fluorogenic hybridization method and sputum fluorogenic smear of 301 cases from May 2002 to November in 2002.Results The sensitivities of sputum fluorogenic hybridization method with,specimen and sputum smear with 1,3 and 6 specimens was 51.9%,49.2%,57.4,61.2% respectively.There was no statistic significance ( P >0.05) of the sensitivities of two methods.The per case cost of test by fluorogenic hybridization method and smear method was 257.47 yuan and 50.17 yuan respectively.Conclusion Fluorogenic hybridization method is rapid and efficient compared with smear examination.But it was expensive.It could not replace the traditional method i.e. smear examination in diagnosing tuberculosis.