RNA恒温实时荧光检测技术对耐多药结核病患者疗效评价的研究OA

Objective To evaluate the clinical value of RNA isothermal real-time fluorescence detection(SAT)technology in monitoring the efficacy of second-line drug therapy in patients with multidrug-resistant tuberculosis(MDR-TB).Methods A total of 74 MDR-TB patients admitted to hospital from January 2022 to January 2023 were enrolled,and sputum specimens were collected at baseline and at 1,2,3,4,5,6,8,10,12,18,and 24 months of treatment.All patients underwent smear acid fast staining,solid culture method,and SAT testing.Clinical diagnostic results was used as gold standard,the trend,sen-sitivity,specificity,and consistency with the final diagnosis of Mycobacterium tuberculosis(MTB)positive rate of three detec-tion methods were analyzed and compared.In addition,the value of SAT in monitoring the efficacy of anti tuberculosis drugs was evaluated.Results ① Acid-fast smear microscopy showed that the positive rate of acid-fast bacilli declined most rapidly,dropping to 21.62％after 2 months of treatment.② Solid culture demonstrated that the MTB positive rate decreased to 31.08％after 2 months of treatment,and the declining trend of MTB positive rate after 3 months of treatment was similar to that of acid-fast smear microscopy.③ SAT showed that the positive rate of MTB gradually decreased with the prolongation of treatment course.After 2 months of treatment,the positive rate of MTB decreased to 43.24％,and after 3 months of treatment,the posi-tive rate of MTB was 23.73％.The positive rates at these two time points were higher than those of acid fast staining and solid culture method detection results at the same time(P<0.05).④ After 6 months of treatment,there was no statistically signifi-cant difference in the monitoring results of tuberculosis positive rate among MDR-TB patients among the three testing methods(P>0.05).After 12 months of self-treatment,the positive rates of all three testing methods remained at 0.⑤After 2 months of treatment,clinical diagnosis results was used as gold standard,the diagnostic consistency Kappa values for smear acid-fast stai-ning detection,solid culture method detection,and SAT were 0.473,0.573,and 0.780,respectively.There was no statisti-cally significant difference in specificity among the three detection methods(P>0.05).SAT demonstrated the highest sensitivi-ty(87.50％),while its accuracy(89.19％)showed no statistically significant difference compared to the solid culture method(79.73％)(P>0.05),but was higher than that of smear acid-fast staining(75.68％)(P<0.05).There were no statistically significant differences in sensitivity and accuracy between smear acid-fast staining and solid culture methods(P>0.05).Con-clusion SAT technology,by targeting live bacterial RNA,demonstrates greater timeliness and accuracy in monitoring the effi-cacy of MDR-TB treatment.Its characteristic of rapidly converting to negative helps guide precise drug discontinuation,addressing the limitations of traditional sputum smear and sputum culture methods.