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结核病LAMP-一种潜在的前进途径,用于诊断抹阴性疑似结核病例
Bharat Kumawat1, Man Mohan Puri1, Manpreet Bhalla2
1Department TB and Respiratory Diseases, National Institute of Tuberculosis and Respiratory Diseases, Sri Aurobindo Marg, New Delhi, India.
The Indian journal of tuberculosis
|December 8, 2025
概括
循环介导同热放大 (TB LAMP) 显示出类似于Xpert MTB/RIF的灵敏度和特异性,用于诊断涂抹阴性结核病. 这种快速诊断工具对检测有希望.
科学领域:
- 微生物学 微生物学
- 传染性疾病 传染性疾病
- 诊断 诊断 诊断 诊断
背景情况:
- 结核病 (TB) 仍然是一个全球性卫生挑战,特别是在发展中国家,诊断是边缘环境中的一个主要障碍.
- 涂抹显微镜,目前的标准,缺乏足够的灵敏度和特异性,需要先进的诊断工具.
- 世界卫生组织 (WHO) 在2016年批准了结核病LAMP作为涂抹显微镜的潜在替代品,但需要进一步的现场数据.
研究的目的:
- 为了评估结核病LAMP与Xpert MTB/RIF相比,在被怀疑结核病的患者中结核病LAMP的性能.
- 评估结核病LAMP的敏感性,特异性,正预测值 (PPV) 和负预测值 (NPV).
- 确定结核病LAMP在识别"隐藏结核病"病例方面的潜力.
主要方法:
- 一项涉及51名临床或放射诊断出结核病的涂抹阴性患者的研究.
- 使用培养物,Xpert MTB/RIF和TB LAMP测定进行微生物学确认.
- 使用培养作为参考标准对诊断准确性的比较分析.
主要成果:
- 在74.50%的样本中,TB LAMP检测到了Mycobacterium tuberculosis.
- 对结核病LAMP和Xpert MTB/RIF的敏感性分别为84.85%和82.35%.
- 结核病LAMP和Xpert MTB/RIF的特异性分别为47.06%和41.1%,结核病LAMP的NPV更高 (87.87%).
结论:
- 结核病LAMP在样阴性疑似结核病患者中表现出与Xpert MTB/RIF相似的敏感性和特异性.
- 结核病LAMP在5%的涂抹负,培养负样本中成功识别了M.tb,这表明"隐藏结核病"的检测潜力.
- 在将结核病LAMP广泛应用于结核病消除计划之前,建议进行进一步的验证研究.
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