The application value of modified Ziehl-Neelsen stain combined with crossing priming amplification assay in diagnosis of pulmonary tuberculosis

doi:10.3969/j.issn.1002-7386.2018.10.017

Abstract：Objective To evaluate the clinical application value of modified Ziehl-Neelsen stain,crossing priming amplification (CPA) assay,and modified Ziehl-Neelsen stain combined with CPA and Xpert MTB/RIF assay in diagnosis of pulmonary tuberculosis.Methods A total of 325 sputum samples of patients with pulmonary tuberculosis who were diagnosed definitely in our hospital from January 2017 to Qctober 2017 were detected by using modified Ziehl-Neelsen stain,CPA,modified Ziehl-Neelsen stain combined with CPA and Xpert MTB/RIF assay,in which,there were 81 cases of smear-positive specimens and 244 cases of smear-negative specimens.Results Among 81 cases of smear-positive specimens,the positive detection rates of modified Ziehl-Neelsen stain,CPA,modified Ziehl-Neelsen stain combined with CPA and Xpert MTB/RIF assay were 91.4％ (74/81),93.8％ (76/81),95.1％ (77/81),96.3％ (78/81),respectively,there were no significant differences in the positive detection rates among the four detection methods (P ＞ 0.05).Among 244 cases of smear-negative specimens,the positive detection rates of the four detection methods were 50.8％ (124/244),53.3％ (130/244),65.6％ (160/244),25.0％ (61/244),respectively.The positive detection rate of modified acid fast stain method was significantly lower than that by the other three detection methods (P ＜ 0.05),however,there were no significant differences among the latter three detection methods (P ＞ 0.05).Moreover the total positive rates detected by the four detection methods were 56.9％(190/325),58.5％ (190/325),97.3％ (244/325),69.3％ (225/325),respectively.Conclusion The modified Ziehl-Neelsen stain,CPA,modified Ziehl-Neelsen stain combined with CPA and with Xpert MTB/RIF assay have better auxiliary diagnosis value in diagnosis of pulmonary tuberculosis.The modified Ziehl-Neelsen stain combined CPA has obtain best detection results both in smear positive and negative specimens,which can substitute the expensive Xpert MTB/RIF assay in primary hospital.