结核病与肺部健康杂志 ›› 2017, Vol. 6 ›› Issue (3): 208-211.doi: 10.3969/j.issn.2095-3755.2017.03.004

• 论著 • 上一篇    下一篇

线性探针技术在骨关节结核快速诊断中的应用价值

盛杰1;吐尔松江·胡达拜尔迪1;古甫丁1;唐伟1;马良1;地里下提·阿布力孜2   

  1. 1830049 乌鲁木齐,新疆维吾尔自治区胸科医院骨科;2新疆维吾尔自治区阿克苏地区库车县传染病医院外科
  • 收稿日期:2017-08-17 出版日期:2017-09-30 发布日期:2017-09-30
  • 作者简介:地里下提?阿布力孜

The application value of line probe assay for rapid diagnosis of osteoarticular tuberculosis

SHENG Jie1,Tuersongjiang·Hudabaierdi1,GU Fu-ding1,TANG Wei1,MA Liang1,Dilixiati·Abulizi2   

  1. 1Department of Orthopaedics,2 Chest Hospital of Xinjiang Uyghur Autonomous Region,Urumqi 830049,China
  • Received:2017-08-17 Online:2017-09-30 Published:2017-09-30

摘要: 目的探讨线性探针技术在骨关节结核快速诊断中的应用价值。方法 回顾性纳入我院骨科2014年1月至2017年2月接受病灶清除手术的157例疑似骨关节结核患者,同时采用线性探针技术、结核分枝杆菌培养及抗酸染色对病灶组织(均为术中切除病灶组织)进行检测。以临床诊断为金标准,计算线性探针技术检测结核分枝杆菌的敏感度、特异度,并结合药物敏感性试验(简称“药敏试验”)结果评价线性探针技术在骨关节结核快速诊断中的应用价值。结果 157例患者中127例临床确诊为骨关节结核,30例为非骨关节结核。线性探针技术、结核分枝杆菌培养及抗酸染色检测手术切除病灶组织的敏感度分别为76.38%(97/127)、55.12%(70/127)、37.01%(47/127),差异有统计学意义(?2=40.06,P<0.05);特异度分别为73.33%(22/30)、76.67%(23/30)、93.33%(28/30),差异无统计学意义(?2=4.50,P=0.11)。与结核分枝杆菌培养及药敏试验相比较,157例患者中,培养+药敏试验10例检测为耐药菌株,线性探针技术也检测出10例耐药菌株,患者与上述10例相同。其中,4例对异烟肼耐药,线性探针技术检测结果均为对异烟肼单耐药;1例对利福平耐药,线性探针技术检测为对异烟肼、利福平同时耐药;其余5例为耐多药结核病,线性探针技术检测结果均为对异烟肼、利福平同时耐药。结论 线性探针技术检测病灶组织中结核分枝杆菌的敏感度高、耗时短,且可同时检测样本中的结核分枝杆菌是否对异烟肼、利福平耐药,对骨关节结核快速诊断及耐药结核早期筛查有较好的临床应用价值。

Abstract: Objective To investigate the value of line probe assay for rapid diagnosis of osteoarticular tuberculosis. Method A total of 157 suspected osteoarticular tuberculosis patients who received focal cleaning were collected between January 2014 to February 2017 in our orthopaedics. Line probe assay, mycobacterial culture, acid-fast stain were used to test the samples at the same time. Taking clinical diagnosis as gold standards, the sensitivity, specificity of line probe assay were calculated. Combine the drug sensitivity test to evaluat the role of line probe assay for rapid diagnosis of osteoarticular tuberculosis. Results In 157 patients, 127 patients were diagnosed with osteoarticular tuberculosis, 30 patients were nontuberculosis. The sensitivity of line probe assay, mycobacterial culture, acid-fast stain were76.38%(97/127)、55.12%(70/127)、37.01%(47/127), and the difference was significant(?2=40.06,P<0.05); The specificity were 73.33%(22/30)、76.67%(23/30)、93.33%(28/30), there was no statistical difference(?2=4.50,P=0.11).Compared with mycobacterial culture and susceptibility testing,10 samples of drug-resistant strains, line probe assay to detect the total 10 samples of drug-resistant strains, with the above 10 samples for the same. Among them, 4 INH-resistant isolates were identified, line probe assay and mycobacterial culture results are consistent; 1 RFP-resistant isolate and 5 multi drug resistant isolates were identified, line probe assay inspection to INH and RFP resistance at the same time. Conclusion The line probe assay is a reliable method with high sensitivity, short time consuming, and the ability to detect drug resistance of INH and RFP simultaneously, can be used for the early screening and rapid diagnosis of osteoarticular tuberculosis.