【摘要】 目的评估线性探针技术(LPA)在四川地区结核分枝杆菌耐药检测中的应用价值。方法对2014-04收集的297例分枝杆菌分离培养物进行传统比例法药敏实验和线性探针检测,分析线性探针技术检测结核分枝杆菌对利福平、异烟肼耐药性及MDR-TB的灵敏度、特异性、阳性预测值、阴性预测值、一致性及Kappa值。结果以传统比例法药敏为金标准,线性探针技术检测利福平耐药情况的灵敏度为90.00%,特异度为96.08%,阳性预测值为78.26%,阴性预测值为98.39%,一致性为95.25%,Kappa值为0.81;检测异烟肼耐药情况的灵敏度为85.00%,特异度为97.87%,阳性预测值为91.07%,阴性预测值为96.23%,一致性为95.25%,Kappa值为0.85;检测MDR-TB的灵敏度为88.46%,特异度为97.40%,阳性预测值为76.67%,阴性预测值为98.87%,一致性为96.61%,Kappa值为0.80。利福平耐药菌株中,rpoB主要突变位点为531、526和516,异烟肼耐药菌株的主要突变位点为katG S315T1。结论线性探针技术能够快速准确的检测利福平、异烟肼的药物敏感性,有利于耐多药结核病的快速筛查和诊断。在基层应用时应加强管理和人员培训。更多还原

【Abstract】 Objective To evaluate application value of line probe assay(LPA)in MDR-TB detection in Sichuan province.Methods 297 strains were collected in April 2014 from Sichuan province and detected by traditional proportion method drug susceptibility test and LPA.Then thesensitivity,specificity,PPV,NPV and consistency of LPA to detect the MDR-TB,the RIF resistance and the IHN resistance were analyzed.Results Compared with the results of traditional proportion method drug susceptibility test,the sensitivity,specificity,PPV,NPV,consistency and kappa of LPA were 90.00%,96.08%,78.26%,98.39%,95.25%and 0.81 regarding the rifampicin resistance,85.00%,97.87%,91.07%,96.23%,95.25%and 0.85 regarding isoniazid resistance,88.46%,97.40%,76.67%,98.87%,96.61%and 0.80 regarding multidrug resistance,respectively.The highest frequency mutation sites are rpoB 531,526 and 516in the rifampicin resistance strains while katG S315T1 in isoniazid resistance strains.Conclusion Compar with traditional methods,LPA can be used for rapid detection of MDR-TB.But management and training the experimenter should be enhanced in local labs.更多还原