荧光PCR熔解曲线法在结核分枝杆菌耐药检测中的临床应用  

Application of fluorescence PCR melting curve method in drug-resistance detection of Mycobacterium tuberculosis

作　　者：王冰冰[1] 郭明日[1] 肖红侠[1] 张立[1] 

机构地区：[1]天津市海河医院检验科,天津300350

出　　处：《国际检验医学杂志》2015年第5期608-609,612,共3页International Journal of Laboratory Medicine

摘　　要：目的评价荧光PCR熔解曲线法在结核分枝杆菌耐药检出中的临床应用价值。方法以改良罗氏培养法及绝对浓度法作为对比,利用荧光PCR熔解曲线法检测53例肺结核患者对利福平、异烟肼耐药情况。结果两种方法的单耐药率、耐多药率比较差异无统计学意义(P>0.05)。同一标本两种方法检测对比显示,与绝对浓度法相比,熔解曲线法检测利福平、异烟肼耐药的敏感度分别为80.0%和81.0%,特异度分别为100.0%和93.8%,准确度分别为92.2%和86.8%,两种方检测法的一致性分析Kappa值分别为0.754和0.710,表明两者一致性佳。结论相对于传统方法,熔解曲线法敏感度、特异度良好且安全、高效,在耐药肺结核治疗中有良好的应用价值。Objective To evaluate the clinical application value of fluorescence PCR melting curve method in the drug-resistance detection of Mycobacterium tuberculosis.Methods With the Lowenstein-Jensen culture method and the absolute concentration method as the comparison,the fluorescent PCR melting curve method was used to detect the resistance to rifampin and isoniazid in53 cases of pulmonary tuberculosis（TB）respectively.Results The single drug resistance rates and multidrug resistance（MDR）rate detected by the two methods had no significant statistical difference（P〉0.05）.The comparison between the two methods for detecting the same sample showed that compared with the absolute concentration method,the sensitivity and specificity of the melting curve method for detecting rifampin-resistance,isoniazid-resistance were 80.0% and 81.0%,100.0% and 93.8% respectively,the accuracies were 92.2% and 86.8% respectively,the Kappa values in the consistency analysis of the two methods were 0.754 and 0.710 respectively,indicating the good consistency between them.Conclusion Compared with the traditional methods,the melting curve method has good sensitivity and good specificity with safety,high efficiency and good application value in the treatment of drug-resistant pulmonary TB.

关 键 词：结核分枝杆菌 耐药肺结核 熔解曲线法 

分 类 号：R446.5[医药卫生—诊断学]