JAMA Intern Med:痰分子检测用于活动性结核病患者病情评估

2018-08-28 zhangfan MedSci原创

研究认为痰分子检测可准确评估活动性结核病患者病情,缩短患者隔离时间,节约医疗费用

新的治疗指南建议采取分子检测取代痰涂片显微检测用于活动性结核病(TB)患者隔离状态的解除,近日研究人员就这种新手段的效果进行了评估。

621名TB住院患者接受痰检,利用GeneXpertMTB/RIF进行痰菌分子检测。研究人员考察患者接受分子检测的依从性和完成度,通过分枝杆菌培养考察检测的准确性,比较新标准实施前后患者接受测试和隔离过程的持续时间、住院时间、隔离和住院的平均天数以及成本。

参与者中,301人在新指南实施前接受至少有1次痰显微镜检查和培养,234例(73%)患者进行了分子检测。TB患者平均年龄54岁,女性占26%。分子检测具有极高的准确性,251例结核分枝杆菌(MTB)培养阴性结果全部排除,所有7例经培养证实的结核全部确诊。与先前的痰检方法相比,获得测试结果的平均时间、终止隔离时间、出院时间显著缩短,TB阴性患者的平均隔离花费节约$13347。

研究认为痰分子检测可准确评估活动性结核病患者病情,缩短患者隔离时间,节约医疗费用。

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  5. [GetPortalCommentsPageByObjectIdResponse(id=1746219, encodeId=2e5f1e4621939, content=<a href='/topic/show?id=6b49e865466' target=_blank style='color:#2F92EE;'>#结核病患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78654, encryptionId=6b49e865466, topicName=结核病患者)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=cf9935672064, createdName=木头人525, createdTime=Thu Jan 10 04:32:00 CST 2019, time=2019-01-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1723935, encodeId=51b41e2393537, content=<a href='/topic/show?id=2d996516e7c' target=_blank style='color:#2F92EE;'>#活动性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=65167, encryptionId=2d996516e7c, topicName=活动性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=596833562866, createdName=楚秀娟, createdTime=Fri Apr 05 12:32:00 CST 2019, time=2019-04-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1765055, encodeId=afac1e6505529, content=<a href='/topic/show?id=df00e086653' target=_blank style='color:#2F92EE;'>#病情#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=70866, encryptionId=df00e086653, topicName=病情)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=778d36, createdName=柳叶一刀, createdTime=Mon Apr 01 23:32:00 CST 2019, time=2019-04-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1254204, encodeId=837c12542049b, content=<a href='/topic/show?id=f30ae86297d' target=_blank style='color:#2F92EE;'>#结核#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78629, encryptionId=f30ae86297d, topicName=结核)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4dfa37, createdName=huhuaidong387, createdTime=Thu Aug 30 04:32:00 CST 2018, time=2018-08-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1609084, encodeId=78191609084f5, content=<a href='/topic/show?id=eb6b1145939' target=_blank style='color:#2F92EE;'>#Med#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11459, encryptionId=eb6b1145939, topicName=Med)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=552a19396740, createdName=ms3994565386320060, createdTime=Thu Aug 30 04:32:00 CST 2018, time=2018-08-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=341469, encodeId=8eb334146946, content=谢谢分享,学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6Nx0VGA4QMDzOP8oAgnV4h51EjSfehJ9QxyiaSmw8PB56BhY8KXFSxHCibXrzcy4abrzSibXQPxJ9kzrLcJyhhB8a/0, createdBy=1d3b1672603, createdName=明月清辉, createdTime=Tue Aug 28 14:14:18 CST 2018, time=2018-08-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=341458, encodeId=1cc5341458f6, content=嗯嗯,学习了。, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2018/07/16/3b24606172648eea459125cb74754afe.jpg, createdBy=6c022216608, createdName=liumin1987, createdTime=Tue Aug 28 13:37:02 CST 2018, time=2018-08-28, status=1, ipAttribution=)]
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    2018-08-28 明月清辉

    谢谢分享,学习了

    0

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    2018-08-28 liumin1987

    嗯嗯,学习了。

    0

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本文的初衷来自于近日呼吸科医师对结核杆菌实验室结果反馈的疑问,问题:为什么本实验室结合杆菌IgG抗体检测(TB-IgG)与结防所结核菌素试验(PPD)经常出现不一致的情况?如何解读?个人对于结核分枝杆菌的认识(M.tuberculosis)仍停留于教科书上一些零星概念层面(分枝杆菌属、革兰阳性杆菌、抗酸染色阳性,罗氏培养基),带着上述问题一方面查阅了相关文献,一方面实地走访了本地区的结核病防治所,

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Infect Dis:结核病影响家庭的灾难性总成本及其决定因素

除了强加于受影响的家庭将经济负担之外,与结核病相关的高成本也会造成资源获取和依从性障碍。这凸显了实现消除结核病战略目标的紧迫

Infect Dis:坦桑尼亚城市成人结核病患者具有明显的临床特征和蠕虫混合感染

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