离心浓缩涂片法检测抗酸杆菌的临床应用价值

目的评价离心浓缩涂片法在检测抗酸杆菌中的应用价值。方法应用离心浓缩涂片法检测926例临床标本，并与直接涂片法、BACTECMGIT-960培养法结果进行比较。结果离心浓缩涂片法的阳性检出率30．9％，显著高于直接涂片法的19．1％（x2=34．2，P〈0．01），而接近于BACTECMGIT-960培养法的32．7％（x2=0．72，P〉0．05），而且检测时间明显缩短为4h；以BACTEC MGIT-960培养结果为金标准，离心浓缩涂片法的敏感性为84．8％（257／303），特异性为95．3％（594／623），准确性为91．9％（851／926）。结论离心浓缩涂片法检测抗酸杆菌简便快速，较直接涂片法检测阳性率有显著提高，具有很高的敏感性和特异性，适合基层实验室推广应用。

Clinical applicable value of centrifugal concentration smear method in determination of acid-fast bacilli

Objective To evaluate the clinical applicable value of centrifugal concentration smear method in determination of acid-fast bacilli (AFB). Methods Centrifugal concentration smear method was used to determine AFB in 926 clinical specimens, the results were compared with those with direct smear method and BACTEC MGIT-960 rapid cultivation method. Results The positive detection rate of centrifugal concentration smear method was 30.9%, significantly higher than that of direct smear method (19.1%) (x2 =34.2,P＜0. 01) and closed to that of BACTEC-960 cultivation method (32.7%) (x2= 0. 72, P＞0. 05). Moreover, the testing time evidently shortened to 4 hours. With the BACTEC MGIT-960 cultivation result as the gold standard, the sensitivity of centrifugal concentration smear method was 84. 8% (257/303), the specificity was 95.3% (594/623) and the accuracy was 91.9%(851/926). Conclusion Centrifugal concentration smear method is convenient and rapid in checking acid-fast bacilli, which has higher positive detection rate, sensitivity and specificity, suitable for spread and application in basic level laboratories.