Xpert MTB/RIF技术在初治涂阴肺结核中的诊断价值  

Diagnostic value of Xpert MTB/RIF in new smear-negative pulmonary tuberculosis

作　　者：刘巧[1] 丁晓艳[1] 竺丽梅[1] 陆伟[1] 孔雯[1] LIU Qiao;DING Xiao -yan;ZHU Li -mei;LU Wei;KONG Wen(Center for Disease Control and Prevention of Jiangsu,Nanjing,Jiangsu 210009,China)

机构地区：[1]江苏省疾病预防控制中心,江苏南京210009

出　　处：《现代预防医学》2019年第3期568-572,共5页Modern Preventive Medicine

基　　金：国家科技重大专项(2014ZX10003001-002-005)

摘　　要：目的探讨Xpert MTB/RIF技术在初治涂阴肺结核患者诊断中的价值。方法选取2014年10月至2016年1月盐城市阜宁县和滨海县临床诊断的341例初治涂阴肺结核患者,对其痰标本进行结核分枝杆菌涂片抗酸染色镜检、罗氏固体培养,并同时进行Xpert MTB/RIF技术检测。结果 341例初治涂阴肺结核中罗氏固体培养阳性39例(11. 44%),阴性302例(88. 56%); Xpert MTB/RIF技术检测阳性52例(15. 25%),阴性289例(84. 75%)。以罗氏固体培养为金标准,Xpert MTB/RIF技术检测结核菌灵敏度为92. 3%,特异性为94. 70%,一致率为94. 43%。Xpert MTB/RIF技术阳性检出中位时间为0天(IQR 0-3),罗氏固体培养阳性检出的中位时间为38天(IQR 19-65)。Xpert MTB/RIF技术共有276例(80. 9%)患者在当天出检测结果,与痰涂片的时效性相仿。结论 Xpert MTB/RIF技术操作简便,时效性好,检测结核分枝杆菌特异性和敏感性较高,对于初治涂阴肺结核的辅助诊断有一定的价值。Objective To explore the diagnostic value of Xpert MTB/RIF in new smear-negative pulmonary tuberculosis patients. Methods From October 2014 to January 2016,341 patients with clinical diagnosis of new smear-negative pulmonary tuberculosis in Funing and Binhai County of Yancheng city were enrolled. The sputum specimens were examined by acid-stain staining,L-J solid culture and Xpert MTB/RIF simultaneously. Results 39 cases( 11. 44%) were culture-positive and 302cases( 88. 56%) were culture-negative,and 52 cases( 15. 25%) were positive by Xpert MTB/RIF. Taking L-J solid culture as the gold standard,the sensitivity and specificity of Xpert MTB/RIF were 92. 3% and 94. 7%,and the consistent rate was94. 43%. The median positive detected time of Xpert MTB/RIF technique was 0 day( IQR 0-3),while that of L-J solid culture was 38 days( IQR 19-65). A total of 276 cases( 80. 9%) were detected on the same day by Xpert MTB/RIF,which was similar to the timeliness of sputum smear. Conclusion The Xpert MTB/RIF detection method has the merits of simple operation,high time-efficiency,specificity and sensitivity,and has a certain value in the adjuvant diagnosis of patients with initial treatment of bacterial negative pulmonary tuberculosis.

关 键 词：涂阴 肺结核 Xpert 诊断 

分 类 号：R181.32[医药卫生—流行病学]