孙娇 1王悦 1孙秀华 1彭娇 1邢黎莉 1孙炳奇1
作者信息
- 1. 110044 沈阳市第十人民医院结核病实验室
- 折叠
摘要
Abstract
Objective To evaluate screening effect of loop-mediated isothermal amplification assay (LAMP) for suspected tuberculosis.Methods A total of 604 suspected tuberculosis patients from Shenyang 10th People's Hospital between May 2015 and June 2016 were selected, and 604 specimens were collected, including 503 sputum, 98 pleural effusions and 3 bronchoalveolar lavage fluid.All specimens were examined by smear microscopy, solid culture, MGIT 960 liquid culture and LAMP, in order to test the different efficacy of four methods, based on clinical diagnosis.The positive detection rate was analyzed by χ2 test, and P<0.05 was considered statistically significant.Results Compared with clinical diagnosis, sensitivities of these four methods were 72.78% (262/360), 51.67% (186/360), 66.67%(240/360) and 59.17% (213/360), respectively;and the specificities were 88.11% (215/244), 99.59% (243/244), 99.59% (243/244) and 99.59% (243/244), what's more, the consistency was good (Kappa value were 0.58, 0.46, 0.61 and 0.54, respectively).The positive detection rate of LAMP in patients with short course (less than 1 year) (45.76% (189/413)) was significantly higher than those of smear microscopy (27.12% (112/413)), MGIT 960 culture (37.05% (153/413)) and solid culture (31.48% (130/413)) (χ2=62.41, 16.62, 40.95, respectively, all P=0.000).In patients with less than 5 symptoms, positive detection rate of LAMP (44.37% (268/604)) was significantly higher than those of microscopy (28.15% (170/604)), liquid culture (36.75% (222/604)) and solid culture (32.12% (194/604)) (χ2=76.22, 21.59 and 47.21, respectively, all P=0.000).For smear negative, liquid culture negative and solid culture negative specimens, LAMP also had high positive detection rate (28.78% (120/417), 21.49% (78/363) and 25.90% (101/390), respectively).Conclusion LAMP is more effective than microscopy, liquid culture and solid culture.It is suitable for the screening of suspected tuberculosis patients with short course, mild clinical symptoms (less than 5 symptoms), smear negative and culture negative.关键词
核酸扩增技术/结核,肺/多相筛查/对比研究Key words
Nucleic acid amplification techniques/Tuberculosis,pulmonary/Multiphasic screening/Comparative study
