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中国防痨杂志 ›› 2018, Vol. 40 ›› Issue (4): 372-377.doi: 10.3969/j.issn.1000-6621.2018.04.006

• 论著 • 上一篇    下一篇

胞内菌抗酸染色法检测体液标本结核分枝杆菌的应用价值

杨翰,崔晓利,李爱芳,尤震宇,谈小文,党丽云()   

  1. 710061 西安市胸科医院
  • 收稿日期:2017-09-19 出版日期:2018-04-10 发布日期:2018-05-14
  • 通信作者: 党丽云 E-mail:dangliyun@sina.com

Application value of intracellular acid-fast staining in detection of Mycobacterium tuberculosis in body fluid specimens

Han YANG,Xiao-li CUI,Ai-fang LI,Zhen-yu YOU,Xiao-wen TAN,Li-yun DANG()   

  1. Xi’an Chest Hospital, Xi’an 710061, China
  • Received:2017-09-19 Online:2018-04-10 Published:2018-05-14
  • Contact: Li-yun DANG E-mail:dangliyun@sina.com

摘要:

目的 探讨胞内菌抗酸染色法检测体液标本结核分枝杆菌的应用价值。方法 收集西安市胸科医院2013年4月至2015年4月共1236份疑似结核病患者的脑脊液(237份)、胸腹腔积液标本(999份)。通过白细胞胞内结核分枝杆菌抗酸染色(改良抗酸染色法,简称“胞内菌法”)、BACTEC MGIT 960液体培养(简称“MGIT 960培养”),及聚合酶链反应荧光探针法(简称“PCR法”)对上述标本进行结核分枝杆菌检测。结果 在胸腹腔积液标本检测中,MGIT 960培养法的敏感度(18.52%,160/864)和阳性率(16.02%,160/999)最高;胞内菌检测法次之(分别为13.66%,118/864;11.81%,118/999),PCR法最低(分别为6.94%,60/864;6.01%,60/999);胞内菌法阳性率与MGIT 960培养法、PCR法比较差异均有统计学意义(χ 2分别为10.26、29.00,P值均<0.01)。在脑脊液标本检测中,胞内菌法检测的敏感度(22.15%,35/158)和阳性率(14.77%,35/237)最高,MGIT 960培养法次之(分别为12.03%,19/158;8.02%,19/237),PCR法最低(分别为3.16%,5/158;2.11%,5/237);胞内菌法阳性率与MGIT 960培养法、PCR法比较差异均有统计学意义( χ 960 2 =5.36,P=0.020; χ PCR 2 =23.36,P=0.020)。 结论 结核分枝杆菌胞内抗酸染色对体液标本中结核分枝杆菌的检验具有重要意义,是一种经济、简单,且达到预期阳性率的检验方法。

关键词: 分枝杆菌,结核, 染色与标记, 诊断技术和方法, 对比研究, 数据说明, 统计

Abstract:

Objective To explore the application value of intracellular acid-fast staining in the detection of Mycobacterium tuberculosis (TB) in body fluid specimens.Methods A total of 1236 body fluid specimens were collected from the patients who were suspected to have TB and sought health care at Xi’an Chest Hospital from April 2013 to April 2015, including 237 cerebrospinal fluid specimens and 999 pleural effusion and ascites specimens. The tests for detection of Mycobacterium tuberculosis were performed to the above samples by using the following methods: acid fast staining of Mycobacterium tuberculosis in leukocytes (modified acid-fast staining method or intracellular staining method), BACTEC MGIT 960 liquid culture of Mycobacterium tuberculosis (MGIT 960 liquid culture method) and polymerase chain reaction (PCR) fluorescence probe method (PCR method).Results As for the pleural effusion specimens, the sensitivity (18.52%, 160/864) and the positive rate (16.02%, 160/999) were found to be the highest ones by using the MGIT 960 liquid culture method, followed by using the intracellular staining method (sensitivity 13.66%, 118/864; positive rate 11.81%, 118/999), the sensitivity (6.94%, 60/864) and the positive rate (6.01%, 60/999) were the lowest ones by using the PCR method. The positive rate by using the intracellular staining method was significantly different from that by using the MGIT 960 liquid culture method and the PCR method ( χ 960 2 =10.26, χ PCR 2 =29.00; P<0.01). For the cerebrospinal fluid specimens, the sensitivity (22.15%, 35/158) and the positive rate (14.77%, 35/237) were the highest ones by using the intracellular acid-fast staining method, followed by using the MGIT 960 liquid culture method (sensitivity 12.03%, 19/158; positive rate 8.02%, 19/237) and the lowest ones were found by using the PCR method (sensitivity 3.16%, 5/158; positive rate 2.11%, 5/237). The positive rate by using the intracellular staining method was significantly higher than that by using the MGIT 960 liquid culture method and the PCR method ( χ 960 2 =5.36, P=0.020; χ PCR 2 =23.36, P=0.020). Conclusion Mycobacterium tuberculosis intracellular acid-fast staining method is very important in detection of Mycobacterium tuberculosis in the body fluid specimens, and it is an economic, simple, achieving the expected positive rate test method.

Key words: Mycobacterium tuberculosis, Staining and labeling, Diagnostic techniques and methods, Comparative study, Data interpretation, statistical