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目的探讨交叉引物扩增技术(crossing priming amplification,CPA)在结核病诊断中的临床应用价值。方法对237例初治结核病患者标本(包括结核性腹膜炎70例,泌尿生殖道结核24例,结核性胸膜炎80例,骨结核13例,淋巴结核16例,结核性脑膜炎34例,其中115例临床确诊为肺外结核)分别进行抗酸染色法、固体培养法及TBCPA法检测,以固体培养法和临床诊断结果为金标准,分析TB-CPA法检测标本中结核分枝杆菌的敏感度、特异度、阳性预测值、阴性预测值和Kappa值。结果以固体培养法和临床诊断结果为金标准,TB-CPA法以及抗酸染色法总体敏感性、特异性、阳性预测值、阴性预测值、Kappa值分别为91.86%(79/86)、87.42%(132/151)、80.61%(79/98)、92.05%(139/151)和0.81,以及53.49%(46/86)、96.03%(145/151)、88.46%(46/52)、122.52%(185/151)和0.54。结论 TB-CPA法可快速检测肺外结核分枝杆菌,具有良好的应用前景。
Objective To investigate the clinical value of crossing priming amplification (CPA) in the diagnosis of tuberculosis. Methods Totally 237 newly diagnosed tuberculosis patients (including 70 cases of tuberculous peritonitis, 24 cases of genitourinary tract tuberculosis, 80 cases of tuberculous pleurisy, 13 cases of bone tuberculosis, 16 cases of lymph node tuberculosis, 34 cases of tuberculous meningitis, of which 115 cases Clinical diagnosis of extrapulmonary tuberculosis) were detected by acid-fast staining, solid culture and TBCPA method to detect the solid culture method and clinical diagnostic results as the gold standard TB-CPA method to detect the sensitivity of Mycobacterium tuberculosis specimens, Specificity, positive predictive value, negative predictive value and Kappa value. Results The sensitivity, specificity, positive predictive value, negative predictive value and Kappa value of TB-CPA and acid-fast staining were 91.86% (79/86) and 87.42 (46/86), 96.03% (145/151), 88.46% (46/52), respectively, which were significantly higher than those in the control group 122.52% (185/151) and 0.54. Conclusion TB-CPA can be used to detect Mycobacterium tuberculosis rapidly and has a good prospect of application.