摘要
目的评估支气管肺泡灌洗液(BALF)应用结核分枝杆菌环介导等温扩增技术(TB-LAMP)对菌阴肺结核诊断中的应用价值。方法收集某院2017年12月—2018年11月临床确诊为菌阴肺结核(3次痰涂片阴性且痰培养阴性)的254例患者的资料,所有患者行支气管检查取支气管镜刷检物或BALF标本,同时分为LAMP组(进行涂片抗酸染色、罗氏培养、TB-LAMP检测)、GeneXpert组(进行涂片抗酸染色、罗氏培养、GeneXpert MTB/RIF检测)。结果LAMP组和GeneXpert组分别纳入96例、158例菌阴肺结核患者,两组患者性别及年龄比较,差异均无统计学意义(均P>0.05)。LAMP组涂片抗酸染色、罗氏培养、TB-LAMP检测阳性率分别为4.17%(4例)、18.75%(18例)、52.08%(50例);GeneXpert组涂片抗酸染色、罗氏培养、GeneXpert MTB/RIF检测阳性率分别为3.80%(6例)、12.66%(20例)、54.43%(86例)。TB-LAMP、GeneXpert MTB/RIF分别与涂片抗酸染色、罗氏培养阳性率比较,差异均有统计学意义(均P<0.05)。TB-LAMP与GeneXpert MTB/RIF对结核分枝杆菌检测阳性率比较,差异无统计学意义。结论BALF应用TB-LAMP对菌阴肺结核具有良好的诊断效能,且具有快速、简单、准确及经济等特点,值得在临床进一步推广应用。
Objective To evaluate the value of bronchoalveolar lavage fluid(BALF)detected by Mycobacterium tuberculosis(MTB)loop-mediated isothermal amplification(TB-LAMP)technique in the diagnosis of smear and culture negative pulmonary tuberculosis(PTB).Methods Clinical data of 254 patients who were clinically diagnosed with smear and culture negative PTB(3 times of both negative sputum smear and negative sputum culture)in a hospital from December 2017 to November 2018 were collected,all patients underwent bronchoscopy for taking bronchoscope brush or BALF specimens,they were divided into LAMP group(performing acid-fast staining smear,Lowenstein-Jensen culture,and TB-LAMP detection)and GeneXpert group(performing acid-fast staining smear,Lowenstein-Jensen culture,and GeneXpert MTB/RIF detection).Results 96 patients and 158 patients with smear and culture negative PTB were included in LAMP group and GeneXpert group respectively,there were no significant differences in gender and age between two groups of patients(both P>0.05).Positive rates of acid-fast staining,Lowenstein-Jensen culture,and TB-LAMP in LAMP group were 4.17%(n=4),18.75%(n=18),and 52.08%(n=50)respectively;positive rates of acid-fast staining,Lowenstein-Jensen culture,and GeneXpert MTB/RIF in GeneXpert group were 3.80%(n=6),12.66%(n=20),and 54.43%(n=86)respectively.Positive rates of TB-LAMP and GeneXpert MTB/RIF were both significantly different from acid-fast staining and Lowenstein-Jensen culture(both P<0.05).Positive rates of MTB detected by TB-LAMP and GeneXpert MTB/RIF was not significantly different.Conclusion Application of TB-LAMP for BALF has a good diagnostic efficacy on smear and culture negative PTB,it is fast,simple,accurate and economical,and is worth of promotion in clinical application.
作者
陈霞
张建勇
赵建军
CHEN Xia;ZHANG Jian-yong;ZHAO Jian-jun(Department of Respiratory and Critical Care Medicine, Affliated Hospital of Zunyi Medical University, Zunyi 563000, China)
出处
《中国感染控制杂志》
CAS
CSCD
北大核心
2020年第7期643-647,共5页
Chinese Journal of Infection Control
基金
贵州省科技厅社会支撑计划(黔科合SY字[2015]3050号)。
关键词
肺泡灌洗液
菌阴肺结核
环介导等温扩增
GeneXpert
MTB/RIF检测
bronchoalveolar lavage fluid
smear and culture negative pulmonary tuberculosis
loop-mediated isothermal amplification
GeneXpert MTB/RIF detection
作者简介
陈霞(1991-),女(汉族),四川省南充市人,硕士研究生,主要从事急性肺损伤研究;通讯作者:赵建军,E-mail:1974zhaojianjun@163.com。
