应用线性探针技术与传统药敏试验检测耐药结核病的成本比较

目的 对比分析线性探针技术（line probe assay，LPA）和传统药敏试验（drug susceptibility testing，DST）在地市级医院实验室检测耐药结核病的成本。 方法 收集3次LPA和DST在内蒙古第四人民医院、连云港市第四人民医院、开封市肺科医院和永川第二人民医院结核病实验室检测不同样本量时使用的所有成本，包括管理费、建筑设备费、试剂耗材和人工等费用，计算2种方法平均检测1例患者的总成本，比较分析4个实验室分别使用两种方法进行耐药检测的平均成本。两样本间均数差异显著性检验采用t检验，P＜0.05为差异有统计学意义。 结果 LPA和DST检测每例患者的平均成本分别为201.0元和365.8元，差异有统计学意义（t=32.28，P<0.01）。LPA和DST检出每例耐多药结核病的单位成本分别为2794.4元和4689.7元，检出1例耐多药结核病，LPA较DST能够节省1895.3元，检测成本明显降低。 结论 LPA检测结核病患者耐药性的单位平均成本明显低于DST，可以考虑在地市级结核病医院实验室应用。

Cost comparison analysis of line probe assay and conventional drug susceptibility testing for diagnosis of drug resistance of Mycobacteria tuberculosis

Objective To compare the costs of line probe assay （LPA） and conventional drug susceptibility testing （DST） for detecting the drug resistance of Mycobacteria tuberculosis in prefectural TB hospitals. Methods The full costs related to LPA and conventional DST including management, building, equipment, reagent, con- sumables and staff were collected from the Fourth People＇s Hospital of Inner Mongolia, the Fourth People＇s Hospital of Lianyungang City, Kaifeng Lung Hospital and the Second People＇s Hospital of Yongchuan District. The average costs of LPA and DST were analyzed by t-test, and the level of significance was set to P~0. 05. Results The average costs for testing one case by LPA and DST were 201.0 Yuan and 365.8 Yuan respectively. The difference was significant （t=32.28, P（0. 01）. The unit costs for identifying one MDR-TB case by LPA and DST were 2794.4 Yuan and 4689.7 Yuan respectively. Compared to conventional DST, 1895.3 Yuan could be saved by LPA for detecting one MDR-TB case, and the testing cost was significantly reduced. Conclusion The cost of LPA for detecting drug resistant TB patient was lower than that of DST. It can be applied in prefectural TB laboratory.