评估临床检查与实验室检查在麻风病诊断中的一致性。
Evaluation of the agreement between clinical and laboratorial exams in the diagnosis of leprosy.
作者信息
Teixeira André Costa, Cruvinel Danilo Lemos, Roma Fábio Rodrigues de, Luppino Leandro Ferreira, Resende Luís Henrique Pereira, Sousa Theo de, Bührer-Sékula Samira, Goulart Isabela Maria Bernardes
机构信息
National Reference Center for Sanitary Dermatology and Leprosy, Clinical Hospital, Faculty of Medicine, Federal University of Uberlândia, MG, Brazil.
出版信息
Rev Soc Bras Med Trop. 2008;41 Suppl 2:48-55. doi: 10.1590/s0037-86822008000700011.
This study examined the correlation between the clinical and laboratory diagnosis of leprosy, using biopsy results from laboratories 'A' and 'B' and the ML Flow test. Clinical and histopathological diagnoses presented 67.6% agreement. The laboratories showed 73.7% agreement in the bacterial index and laboratory 'B' detected 25.4% more positives. The highest agreement was in the LL form and lowest, in the I form. The highest diagnostic discrepancy was for the BB form. Clinical diagnosis agreement was 41.3% for laboratory 'A' and 54% for 'B'. The ML Flow test reclassified 10.7% of the patients. The spectrum of leprosy classification is important for a clearer understanding of the disease and its proper treatment, but is not used in health services, which use the simplified WHO criteria. This could be complemented by ML Flow testing. Such simplification is unacceptable for Leprosy Reference Centers regarding patient attendance, teaching and research, for which the standardization of the Ridley-Jopling classification is recommended.
本研究利用“A”和“B”实验室的活检结果以及ML Flow检测，对麻风病的临床诊断与实验室诊断之间的相关性进行了研究。临床诊断与组织病理学诊断的一致性为67.6%。两个实验室在细菌指数方面的一致性为73.7%，且实验室“B”检测出的阳性病例多25.4%。一致性最高的是LL型，最低的是I型。诊断差异最大的是BB型。实验室“A”的临床诊断一致性为41.3%，“B”为54%。ML Flow检测对10.7%的患者进行了重新分类。麻风病分类谱对于更清晰地了解该疾病及其恰当治疗很重要，但在使用世界卫生组织简化标准的卫生服务中并未采用。ML Flow检测可作为补充。对于麻风病参考中心的患者就诊、教学和研究而言，这种简化是不可接受的，建议采用里德利 - 乔普林分类法的标准化。
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