摘要
近一年来,结核病的诊断方面继续深入进行相关方面的研究,取得了不少进步.在细菌学诊断方面,使用新技术如新型移动数字化荧光显微镜痰检涂片技术可清晰显示并保存图像,发光二极管（LED）性能的荧光显微镜（FM）检查能够明显缩短常规涂片的染色时间,明显提高检出率.影像学诊断在结核病诊断的难点方面进行了详细的研究,如肺癌合并肺结核的临床分期、耐多药结核病与非结核分枝杆菌病的鉴别等.γ干扰素释放试验诊断结核分枝杆菌感染具有很大优势,今年对其诊断价值进行再评价.分子生物学诊断发展迅速,继续对XpertMtb/RIF诊断系统进行深入研究,超支化滚环扩增（hyperbranched rolling circle amplification,HRCA）技术简单、经济、省时,在贫困地区具有广泛的应用前景.介入诊断方面,将气管镜、腔镜技术与分子生物学、超声引导技术、细菌学、病理学检测技术相结合,使得结核病的诊断效率得到显著的提高,如气管镜下支气管冲洗液进行XpertMtb/RIF的检测等.病理学诊断方面以分子病理技术的发展较引人注目,使用活检标本行基因检测提高了结核病的检出率.
Much progress has been made on the clinical diagnosis of tuberculosis （TB） in recent one year by series studies.In bacteriological diagnosis,novel sputum-smear techniques such as mobile digital fluorescence microscopy can clearly show and save the images of bacteria,light-emitting diode （LED） fluorescence microscopy （FM） can greatly shorten the time of detection and increase the detection rate compared with conventional acid-fast staining methods.Particular studies had been made on the difficulties of TB diagnosis in radiology,for example,the clinical stages of lung cancer with pulmonary TB （PTB） and differential diagnosis of multidrug resistant PTB and nontuberculosis mycobacterium （NTM）.IGRAs （interferon gamma release assay） have great advantage in diagnosis of latent TB infection.Its diagnosis value has been further re-evaluated in this year.Rapid development was obtained in molecular biological diagnosis of TB,the value of Xpert Mtb/RIF has been further evaluated; hyperbranched rolling circle amplification （HRCA） for direct detection of Mycobacterium tuberculosis proved to be simple,economic and fast,which has wide prospect of application in resource limited areas.In interventional diagnosis of TB,the combination of several techniques such as bronchoscopy,endoscope,molecular biology,ultrasonic guided technique,bacteriology and pathology made great progress in the diagnosis of TB,for example,the bronchial washing liquid from TB patients through bronchoscope was detected by Xpert Mtb/RIF.The development of molecular pathological diagnosis on TB is outstanding.Gene detection of Mycobacterium tuberculosis in the biopsy tissue remarkably increased the TB detection.
出处
《中国防痨杂志》
CAS
2014年第8期714-740,共27页
Chinese Journal of Antituberculosis
关键词
结核
诊断
细菌学技术
诊断显像
Γ干扰素释放试验
核酸扩增技术
生物学标记
微生物敏感性试验
Tuberculosis/diagnosis
Bacteriological techniques
Diagnostic imaging
Interferon-gamma release tests
Nucleic acid amplification techniques
Biological markers
Microbial sensitivity tests
