目的: 探讨结核分枝杆菌(Mycobacterium tuberculosis,MTB)分泌蛋白胶体金法检测患者痰液在肺结核诊断中的临床应用价值。方法: 选取2020年10月至2020年12月在滨州市中心医院确诊的住院肺结核患者173例作为研究对象,留取晨痰,分别采用痰抗酸染色涂片镜检法、痰培养法、MTB分泌蛋白胶体金法、GeneXpert MTB/RIF法进行检测,对比不同方法的诊断效能。结果: 173例患者痰涂片阳性59例(34.10 %),痰培养阳性66例(38.15 %),痰胶体金阳性90例(52.02 %),GeneXpert MTB/RIF法阳性102例(58.96 %)。痰胶体金法与痰培养结果比较差异有统计学意义(χ2=6.724,P=0.010);GeneXpert MTB/RIF法和痰培养法结果比较差异有统计学意义(χ2=14.995,P＜0.001);痰胶体金法与GeneXpert MTB/RIF法结果比较差异无统计学意义(χ2=1.685,P=0.194)。173例患者痰液检测,菌阳组阳性检出率明显高于菌阴组(χ2=45.146,P＜0.001;χ2=49.406,P＜0.001);通过痰胶体金法,菌阳组和菌阴组检出结果差异有统计学意义(χ2=45.146,P＜0.001),但初治和复治患者之间,结果比较差异无统计学意义(χ2=0.160,P=0.689)。结论: MTB分泌蛋白胶体金法检测患者痰液在肺结核诊断中有较大临床价值,且快速、简便,值得推广应用。
Objective: To evaluate clinical application of MTB secreted protein colloidal gold method in diagnosis of pulmonary tuberculosis using sputum sample. Methods: A total of 173 cases of hospitalized tuberculosis patients diagnosed in Binzhou Central Hospital from October 2020 to December 2020 were selected as research objects, and morning sputum was collected and detected by acid-fast staining smear microscopy, sputum culture, MTB secreted protein colloidal gold method and GeneXpert MTB/RIF method, respectively. Diagnostic efficacy was compared in different groups. Results: Among the samples from 173 patients, 59 (34.10 %) were positive by sputum smear, 66 (38.15 %) were positive by sputum culture, 90 (52.02 %) were positive by colloidal gold, and 102 (58.96 %) were positive by GeneXpert MTB/RIF method. There was significant difference between sputum colloidal gold method and sputum culture results (χ2=6.724, P=0.010); the results of GeneXpert MTB/RIF method and sputum culture method were significantly different (χ2=14.995, P＜0.001); there was no significant difference between the results of sputum colloidal gold method and GeneXpert MTB/RIF method (χ2=1.685, P=0.194). The sputum samples of 173 patients was detected, and the positive rate of the bacteria positive group was significantly higher than bacteria negative group(χ2=45.146, P＜0.001;χ2=49.406, P＜0.001). By the sputum colloidal gold method, there was a statistically significant difference between bacteria positive group and bacteria negative group (χ2=45.146, P＜0.001), but there was no significant difference between initial treatment and retreatment (χ2=0.160, P=0.689). Conclusion: MTB secreted protein colloidal gold method has promising clinical value in tuberculosis diagnosis, which is rapid, simple and worth for clinical application widely.
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