耐GeneXpert MTB/RIF检测技术在肺结核诊断及利福平耐药分析中的应用研究

胡晓蓉; 宋江勤

文章摘要

耐GeneXpert MTB/RIF检测技术在肺结核诊断及利福平耐药分析中的应用研究

Study on the application of GeneXpert MTB/RIF detection technology in the diagnosis of pulmonary tuberculosis and rifampicin resistance

DOI：10.3969/j.issn.1007-8134.2022.05.015

中文关键词: GeneXpert MTB/RIF 肺结核耐药利福平灵敏度特异度诊断一致性药物敏感试验

英文关键词: GeneXpert MTB/RIF pulmonary tuberculosis drug resistance rifampi sensitivity specificity diagnostic consistency drug sensitivity test

基金项目:

作者	单位
胡晓蓉	天门市第一人民医院检验科
宋江勤	天门市第一人民医院检验科

摘要点击次数: 196

全文下载次数: 0

中文摘要:

[摘要]?目的?探讨GeneXpert MTB/RIF检测技术在肺结核诊断中的应用价值。方法?以2020年7月—2021年6月在天门市第一人民医院治疗的疑似肺结核患者107例作为研究对象，所有患者均留取痰标本，进行痰涂片、痰培养、GeneXpert MTB/RIF检测、比例法药敏试验。以培养法和比例法药敏结果为金标准，计算GeneXpert MTB/RIF检测结核分枝杆菌（Mycobacterium tuberculosis，MTB）及其对于利福平耐药性检测的灵敏度、特异度、与金标准的的一致率。结果?107例疑似肺结核患者中，痰涂片阳性39例（36.45%），涂片阴性68例（63.55%）。以痰培养结果为金标准，GeneXpert MTB/RIF检测TBM的灵敏度为85.42%（41/48），特异度为88.14%（52/59）。GeneXpert MTB/RIF与痰培养诊断一致率为86.92%（93/107）；进一步分析，GeneXpert MTB/RIF检测痰涂片阳性患者MTB的灵敏度为97.22%（35/36），特异度为33.33%（1/3），检测涂片阴性患者MTB的灵敏度为50.00%（6/12），特异度为91.07%（51/56）。以比例法药敏结果为金标准，确认痰培养阳性36例患者中利福平耐药有4例（11.11%），敏感的有32例（88.89%）；GeneXpert MTB/RIF检测痰培养阳性患者利福平耐药的灵敏度为75.00%（3/4），特异度为93.75%（30/32）。GeneXpert MTB/RIF与比例法药敏试验一致率为91.67%。结论?GeneXpert MTB/RIF检测技术对于肺结核诊断以及利福平的耐药分析具有重要实用价值，可以作为金标准。

英文摘要:

[Abstract]　Objective?To explore the value of GeneXpert MTB/RIF detection technology in the diagnosis of pulmonary tuberculosis and rifampicin resistance. Methods?A total of 120 suspected pulmonary tuberculosis patients treated in the First People’ s Hospital of Tianmen from July 2020 to June 2021 were collected as the research objects. Respiratory tract sputum specimens were collected from all patients for sputum smear, sputum culture, GeneXpert MTB/RIF and drug sensitivity test by proportional method. The results of sputum culture and proportion method drug sensitivity test were used as the gold standard to calculate the sensitivity, specificity and consistency of GeneXpert MTB/RIF assay with the gold standard in detecting Mycobacterium tuberculosis (MTB) and its resistance to rifampicin. Results?Of 120 suspected pulmonary tuberculosis patients, 42 cases (35.00%) were were positive for sputum smear,and 78 cases (65.00%) were negative for smear. Taking sputum culture results as the gold standard, the sensitivity of all patients was 85.42% (41/48) and the specificity was 88.14% (52/59). Agreement value of GeneXpert MTB/RIF and solid culture was 86.92%. Further analysis, the sensitivity of GeneXpert MTB/RIF assay for detecting MTB in smear-positive patients was 97.22% (35/36), and the specificity was 33.33% (1/3); the detection sensitivity was 50.00% (6/12) and the specificity was 91.07% (51/56). Using the ratio method as the gold standard, there were 4 of the 36 patients with positive sputum culture (11.11%) were positive for rifampicin resistance were, and 32 patients (88.89%) were sensitive. GeneXpert MTB/RIF detected patients of sputum culture positive, the sensitivity of rifampicin resistance was 75.00% (3/4), and the specificity was 93.75% (30/32). At the same time, Kappa test was performed on GeneXpert MTB/RIF and ratio method drug susceptibility test in this study, the agreement value was 91.67%, and the 2 had good consistency. Conclusions?GeneXpert MTB/RIF detection technology is of great significance for the diagnosis of pulmonary tuberculosis and the analysis of rifampicin resistance.

HTML 查看全文下载PDF阅读器

关闭