目的 探讨环介导等温扩增法(LAMP)检测结核分枝杆菌在基层诊疗机构中的临床应用价值.方法 采用LAM P法及抗酸染色涂片法对140例临床诊断为肺结核的患者的痰标本进行检测.统计分析采用McNemar检验和 Kappa检验.结果 140例痰标本中,抗酸染色涂片法及 LAMP法的阳性检出率分别为29 .3%(41/140)和45 .0%(63/140) .与抗酸染色涂片法比较,LAM P法的灵敏度为97 .6%(40/41) 、特异度为76 .8%(76/99) ,总体一致率82 .9%(116/140) .两种方法一致性相比,差异有统计学意义(Kappa＝ 0 .642 , P＜0 .05) ,两者一致性良好.在检测时间上,与涂片法相比,大批量标本检测中 LAM P 法所用时间较短.结论 痰标本检测中,LAM P法阳性检出率优于抗酸染色涂片法,批量检测性好,具有较好的临床应用前景.%Objective To explore the clinical value of a loop-mediated isothermal amplification (LAMP) method for detection of Mycobacterium tuberculosis in the application of primary medical institutions . Methods The sputum samples from 140 patients with clinically diagnosed pulmonary tuberculosis detected by LAMP and anti-acid staining method .McNemar test and Kappa test were used for statistical analysis . Results In 140 cases of sputum ,the positive detection rate of anti-acid staining and LAMP method was 29 .3%(41/140)and 45 .0%(63/140) .Compared with the smear method ,the sensitivity of LAMP method was 97 .6%(40/41) ,the specificity was 76 .8%(76/99) .The overall consensus rate was 82 .9%(116/140) .Com-pared with the two methods ,the consistency between the two is moderate and statistically significant (Kappa＝0 .642 ,P＜0 .05) .Compared with the smear method ,the LAMP method used in large-scale specimen examination takes shorter time .Conclusion In sputum sample detection ,positive detection rate of LAMP method is better than antacid staining smear method .It has good batch detection ability and good clinical application prospect .
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