结核分枝杆菌检测方法的比较研究-现代医学

结核分枝杆菌检测方法的比较研究

单位：1. 东部战区总医院病理科, 江苏南京 210002;
2. 南京医科大学附属脑科医院病理科, 江苏南京 210029

关键词：纤维支气管镜结核分枝杆菌外周血结核感染T细胞检测抗酸染色实时荧光聚合酶链反应

分类号：R378.91

出版年·卷·期（页码）：2020·48·第十二期（1564-1567）

摘要：

目的： 比较外周血结核感染T细胞检测、抗酸染色和实时荧光聚合酶链反应法（qRT-PCR）检测结核分枝杆菌的灵敏度，探索临床检出结核分枝杆菌的更优方案。方法： 选取临床确诊的80例肺结核患者，应用抗酸染色法及qRT-PCR回顾性检测其纤维支气管镜活检标本，并与其外周血结核感染T细胞检测结果相比较。结果： 80例临床确诊肺结核病例中，传统的外周血结核感染T细胞检测阳性66例，qRT-PCR检测阳性76例，抗酸染色检测阳性75例。抗酸染色和qRT-PCR检测的灵敏度高于外周血结核感染T细胞检测，差异均有统计学意义（均P<0.05），联用抗酸染色和qRT-PCR检测结核分枝杆菌阳性78例，在其单独运用的基础上又进一步提高了灵敏度。结论： 经纤维支气管镜活检取出的有限标本中，若标本充足应先行灵敏度较高qRT-PCR检测，联合抗酸染色可使灵敏度进一步提高。

Objective: To explore a better solution for clinical detection of mycobacterium tuberculosis by using the combination of T-SPOT.TB, Ziehl-Neelsen and fluorescent quantitative polymerase chain reaction(qRT-PCR). Methods: Ziehl-Neelsen and qRT-PCR were used to detect mycobacterium tuberculosis in 80 patients with clinical diagnosis of pulmonary tuberculosis, the results were compared with T-SPOT.TB. Results: Among the 80 cases of clinical confirmed tuberculosis, 66 cases were positive by the traditional T-SPOT.TB, 76 cases were positive by qRT-PCR, 75 cases were positive by Ziehl-Neelsen. The sensitivity of Ziehl-Neelsen and qRT-PCR detection was higher than that T-spot.TB, and the difference was statistically significant (P<0.05),78 cases of mycobacterium tuberculosis were positive by Ziehl-Neelsen and qRT-PCR, the sensitivity was higher than that using them alone. Conclusion: Limited by bronchoscopic biopsy specimens of fibers withdrawn, qRT-PCR should be performed first, and the sensitivity can be further improved if combined with Ziehl-Neelsen.

参考文献：

[1] WANG Q J,HAN W,NIU J M,et al.Prognostic value of serum macrophage migration inhibitory factor levels in pulmonary tuberculosis[J].Respir Res,2019,20(1):50.
[2] WANG L,ZHANG H,RUAN Y,et al.Tuberculosis prevalence in China,1990-2010; a longitudinal analysis of national survey data[J].Lancet,2014,383(9934):2057-2064.
[3] ZHAO Y L,XU S F,WANG L X,et al.National survey of drug-resistant tuberculosis in China[J].New Engl J Med,2012,366(23):2161-2170.
[4] MENG C Y,SHEN Y J,WANG J,et al.A two-step algorithm for rapid diagnosis of active pulmonary tuberculosis in entry applicants using the T-SPOT.TB and Xpert MTB/RIF assays in shanghai,China[J].Emerg Microbes Infect,2017,6(7):e67.
[5] 邹立新,陈兰.结核分枝杆菌的快速检测和药敏实验[J].国际检验医学杂志,2015,36(11):1606-1608.
[6] 李小燕,吴丹,姚梅宏,等.抗酸染色与即时荧光定量PCR法检测结核分枝杆菌在辅助诊断结核病中的作用比较[J].中华病理学杂志,2018,47(2):132-134.
[7] LI K,YANG C Y,JIANG Z C,et al.Quantitative investigation of factors relevant to the T cell spot test for tuberculosis infection in active tuberculosis[J].BMC infect dis,2019,19(1):673.
[8] DOAN T N,EISEN D P,ROSE M T,et al.Interferon-gamma release assay for the diagnosis of latent tuberculosis infection:a latent-class analysis[J].PLoS One,2017,12(11):e0188631.
[9] BOSSHARD V,METZGER M,PERNEGER T,et al.Do results of the T-SPOT.TB interferon-gamma release assay change after treatment of tuberculosis[J].Respir Med,2009,103(1):30-34.
[10] PARK I N,SHIM T S.Qualitative and quantitative results of interferon-γ release assays for monitoring the response to anti-tuberculosis treatment[J].Korean J InternMed,2017,32(2):302-308.
[11] 罗春卉.结核感染T细胞检测对活动性肺结核患者诊断效能的影响[J].实验与检验医学,2019,37(2):301-303.

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