[1]刘文静a,伊 洁a,窦亚玲a,等.实时荧光PCR和六胺银染色对肺孢子菌肺炎诊断价值的分析评价[J].现代检验医学杂志,2017,32(05):28-31.[doi:10.3969/j.issn.1671-7414.2017.05.008]
　LIU Wen-jinga,YI Jiea,DOU Ya-linga,et al.Evaluation of Real-time PCR and Gomori-Methenamine Silver Stain for Diagnosing of Pneumocystis Pneumonia[J].Journal of Modern Laboratory Medicine,2017,32(05):28-31.[doi:10.3969/j.issn.1671-7414.2017.05.008]
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实时荧光PCR和六胺银染色对肺孢子菌肺炎诊断价值的分析评价()
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《现代检验医学杂志》[ISSN:/CN:]

卷:
第32卷
期数:
2017年05期
页码:
28-31
栏目:
论著
出版日期:
2017-11-02

文章信息/Info

Title:
Evaluation of Real-time PCR and Gomori-Methenamine Silver Stain for Diagnosing of Pneumocystis Pneumonia
文章编号:
1671-7414(2017)05-028-04
作者:
刘文静a; 伊 洁a; 窦亚玲a; 谢秀丽a; 刘正印b; 徐英春a
北京协和医院a.检验科; b.感染内科,北京 100730
Author(s):
LIU Wen-jinga; YI Jiea; DOU Ya-linga; XIE Xiu-lia; LIU Zheng-yinb; XU Ying-chuna
a.Department of Clinical Laboratory; b.Department of Infectious Disease, Peking Union Medical College Hospital,Beijing 100730,China
关键词:
实时荧光PCR;  六胺银染色;  肺孢子菌肺炎
分类号:
R379.9; Q503
DOI:
10.3969/j.issn.1671-7414.2017.05.008
文献标志码:
A
摘要:
目的 比较实时荧光PCR和六胺银染色对肺孢子菌肺炎(PCP)的诊断价值。方法 收集2014年1～12月北京协和医院疑似PCP患者非重复送检标本共2 525例,其中2 492例标本用六胺银染色法对肺孢子菌孢囊进行检测,33例标本用实时荧光PCR法对PCP-DNA进行检测,429份标本同时用六胺银染色法和实时荧光PCR法进行检测,以临床诊断为标准,分析两种方法的阳性率、敏感度、特异度、阳性预测值和阴性预测值。结果 六胺银染色法的阳性率为1.2%(30/2 492),其中痰、气管插管支气管吸取物和肺泡灌洗液的阳性率分别为0.70%(13/1 845),4.00%(10/250)和2.72%(7/257)。实时荧光PCR法的阳性率为34.20%(158/462),痰和肺泡灌洗液的阳性率分别为30.61%(105/343)和44.54%(53/119)。六胺银染色法和实时荧光PCR法的敏感度13.97% vs 72.07%(χ2=68.625,P<0.01),特异度100% vs 94.24%(χ2=4.296,P<0.05),阳性预测值100% vs 92.14%(χ2=6.380,P<0.01),阴性预测值55.36% vs 78.26%(χ2=11.873,P<0.01),差异均具有统计学意义。结论 实时荧光PCR敏感度高,相对干扰因素少,临床诊断价值高,但标本送检率明显低于六胺银染色,建议临床提高其送检率,提高PCP的早期诊断。
Abstract:
Abstract:Objective To compare real-time PCR and gomori-methenamine silver stain in the diagnosis of pneumocystis peumonia(PCP).Methods 2 525 unrepeated specimens from suspected PCP patient admitted in Peaking Union Medical College Hospital were collected in 2014.2 492 samples were detected by gomori-methenamine silver stain,33 samples were detected by real-time PCR,and 429 samples were detected by both methods at the meanwhile.With clinical diagnosis as reference standard,the sensitivity,specificity,positive predictive value and negative predictive value of the two methods were analysised.Results Positive rate of gomori-methenamine silver stain was 1.2%(30/2 492).The first three specimen types were sputum,tracheal intubation suction and bronchoalveolar lavage fluid,the positive rate was 0.70%(13/1 845),4.00%(10/250)and 2.72%(7/257)respectively.Positive rate of realtime PCR was 34.20%(158/462),and the positive rate of sputum and bronchoalveolar lavagefluid was 30.61%(105/343)and 44.54%(53/119)respectively.The sensitivity were 13.97% vs 72.07%,specificity were 100% vs 94.24%,positive predictive value were 100% vs 92.14% and negative predictive value were 55.36% vs 78.26% for gomori-methenamine silver stain and real-time PCR respectively.All of which were statistically significant analysed by χ2 test for paired data.The χ2 value and P alue were χ2=68.625,P<0.01; χ2=4.296,P<0.05; χ2=6.380,P<0.01 and χ2=11.873,P<0.01.Conclusion The real-time PCR had higher sensitivity,fewer interference factors and more clinical diagnostic value,so clinicians should make more use of real-time PCR to diagnose PCP earlier.

参考文献/References:

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备注/Memo

备注/Memo:
基金项目:公益性行业科研专项资助(201402001)。 作者简介:刘文静(1984-),女,硕士,实习研究员,主要从事临床微生物及分子检验,E-mail:liuwenjing1220@139.com。 通讯作者:徐英春(1964-),男,研究员,博士生导师,研究方向:临床微生物,E-mail:xycpumch@139.com。
更新日期/Last Update: 1900-01-01