环介导等温扩增法诊断初诊肺结核病研究

目的:初步评价环介导等温扩增法(Lamp)检测痰中结核分枝杆菌的准确性,探讨临床诊断初诊肺结核病人的应用价值。方法:选取249例初诊疑似肺结核病人的痰标本,同时进行Lamp、直接涂片抗酸染色法和改良罗氏培养基培养法检测。结果:剔除培养失败和非结核杆菌的标本,共检测了739份痰标本,其中直接涂片抗酸染色法检出阳性标本70份,阳性率9.47%;培养检出阳性标本118份,阳性率15.97%;Lamp检出阳性标本99份,阳性率13.40%。以培养法为标准,涂片法的灵敏度57.63%,特异度99.68%,符合率为94.30%;Lamp的灵敏度77.12%,特异度98.71%,符合率为96.61%。结论:Lamp在检测初诊疑似肺结核病人中有较高的灵敏度和特异性,适用于基层结核病工作中初诊肺结核病人的诊断。

A evaluation on loop mediated isothermal amplification method for detecting diagnosed first patients with pulmonary tuberculosis

Objective:To evaluate the accuracy and explore the value of loop mediated isothermal amplification method(lamp) for detecting Mycobacterium tuberculosis in sputum from first diagnosed patients with pulmonary tuberculosis.Methods: Sputum specimens from 249 cases who were firstly diagnosed as suspected pulmonary tuberculosis were selected for detection by loop mediated isothermal amplification method,direct smear acid-fast staining and Lowenstein-Jensen medium at the same time.Results: Of 739 sputum samples that do not include 1 samples identified no tuberculosis mycobacterium and 7 samples culture fail,70 samples were smear-positive(9.47%),118 samples were culture positive(15.97%),99 samples were lamp positive(13.40%).Comparing with culture method,the sensitivity of smear was 57.63%,specificity of smear was 99.68%,and coincidence rate was 94.30%;the sensitivity of lamp was 77.12%,the specificity of lamp was 98.71%,and coincidence rate was 96.61%.Conclusion: LAMP,with the better sensitivity and specificity for detecting fist diagnosed patients with pulmonary tuberculosis,was suitable for diagnosis of tuberculosis at county level.