四种检测方法在结核病诊断中的比较

目的 比较分析MGIT960液体培养法、结核/非结核分枝杆菌核酸检测(PCR-荧光探针法)、Xpert MTB/RIF和直接涂片镜检在结核病诊断中的应用。方法 收集我院2019年5～12月临床上疑似为结核病患者的各类标本。将疑似结核病患者2天内所有的标本混匀后进行直接涂片镜检,然后平均分装为3份,进行MGIT960液体培养、PCR-荧光探针法和Xpert MTB/RIF。结果 2019年5～12月间总共收集了我院710份疑似结核病患者的各类标本。直接涂片镜检、PCR-荧光探针法、MGIT960液体培养和Xpert MTB/RIF检测结核分枝杆菌的阳性率分别为12.0%、18.7%、21.4%和24.8%。以临床诊断作为参考标准时,直接涂片法、PCR-荧光探针法、MGIT960液体培养和Xpert MTB/RIF检出结核分枝杆菌的灵敏度分别为40.2%、60.3%、78.4%和70.1%,而特异度分别为98.6%、96.9%、100.0%和92.2%,且四种方法组间比较均具有统计学差异。结论 四种临床检测方法在结核病诊断中各有优缺点,联合应用可以更好的诊断、治疗和监测结核病。

Comparison of four detection methods in the diagnosis of tuberculosis

Objective To compare and analyze the application of MGIT960 liquid culture method, tuberculosis/nontuberculous nucleic acid detection(PCR-fluorescent probe method), Xpert MTB/RIF and direct smear microscopy in the diagnosis of tuberculosis.Methods Various specimens from clinically suspected tuberculosis patients in our hospital from May to December 2019 were collected.All specimens from suspected tuberculosis patients were mixed in two days, then directly smeared for microscopy, and then divided into three equal parts for MGIT960 liquid culture, PCR-fluorescent probe method and Xpert MTB/RIF.Results A total of 710 specimens of suspected tuberculosis patients were collected from our hospital from May 2019 to December 2019.The positive rates of direct smear microscopy, PCR-fluorescent probe method, MGIT960 liquid culture and Xpert MTB/RIF detection of Mycobacterium tuberculosis were 12.0%, 18.7%, 21.4% and 24.8%, respectively.Taking clinical diagnosis as the reference standard,the sensitivity of detecting Mycobacterium tuberculosis by direct smear method, PCR-fluorescent probe method,MGIT960 liquid culture, and Xpert MTB/RIF was 40.2%, 60.3%, 78.4%, and 70.1%, respectively, and the specificity was 98.6%, 96.9%, 100.0%, and 92.2%, respectively, and the differences were statistically significant.Conclusion The four clinical detection methods have their own advantages and disadvantages in the diagnosis of tuberculosis, and the combined application can better diagnose, treat and monitor tuberculosis.