RNA恒温扩增实时荧光检测技术对结核性胸腔积液的诊断价值

目的 探讨RNA恒温扩增实时荧光检测技术(simultaneous amplification and testing, SAT-TB)对结核性胸腔积液的诊断价值。方法 选取2014年6月至2016年6月聊城市传染病医院收治的有胸腔积液的患者210例作为研究对象,其中143例临床诊断为结核性胸膜炎,作为结核性胸膜炎组;其余67例患者作为对照组。应用涂片法、改良罗氏培养法、SAT-TB法检测研究对象胸腔积液标本,比较各检测方法的检测效能。结果 SAT-TB检测的敏感度、特异度、阳性预测值、阴性预测值分别为36.36%(52/143)、98.51%(66/67)、98.11(52/53)、42.04%(66/157)。SAT-TB检测的敏感度明显高于涂片法3.50%(5/143)]及罗氏培养法20.28%(29/143)],差异均有统计学意义(χ ²=19.08,P=0.021;χ ²=9.12,P<0.01)。SAT-TB法检测完成时间为1~2h,罗氏培养法完成时间为6~8周。 结论 SAT-TB法能快速检测胸腔积液中的结核分枝杆菌,敏感度高于涂片法和罗氏培养法。

The diagnosis value of simultaneous amplification and testing for tuberculous pleural effusion

Objective To evaluate the diagnosis value of simultaneous amplification and testing (SAT-TB) for tuberculous pleural effusion.Methods Two hundred and ten cases with pleural effusion admitted from Liaocheng Infectious Disease Hospital from June 2014 to June 2016 were selected as the subjects. Among them, 143 patients were clinically diagnosed as tuberculous pleurisy (defined as tuberculous pleurisy group, while the remaining 67 patients were defined as the control group. The specimens of pleural effusion were collected from all subjects and analyzed by the smear test, modified Roche culture method and SAT-TB method. The detection performances of the three methods were compared.Results The sensitivity, specificity, positive predictive value, and negative predictive value of SAT-TB were 36.36% (52/143), 98.51% (66/67), 98.11 (52/53), and 42.04% (66/157). The sensitivity of SAT-TB was higher than that of the smear test (3.50%, 5/143) and modified Roche culture method (20.28%, 29/143); the differences were statistically significant (χ ²=19.08, P=0.021; χ ²=9.12, P<0.01). The detection time of SAT-TB was one to two hours, while the modified Roche culture method needed six to eight weeks. Conclusion SAT-TB is a rapid method for detection of Mycobacterium tuberculosis in pleural effusion, and its sensitivity is superior to the smear test and modified Roche culture method.