Xpert MTB/RIF检测痰标本结核分枝杆菌与利福平耐受性的临床应用研究  

Study on clinical application of Xpert MTB/RIF for detecting Mycobacterium Tuberculosis in sputum sample and rifampicin resistance

作　　者：李静[1] 林日文 张灿强 

机构地区：[1]广东省惠州市结核病防治研究所检验科,516008 [2]广东省惠州市惠城区慢性病防治站检验科,516000

出　　处：《国际检验医学杂志》2017年第4期480-482,共3页International Journal of Laboratory Medicine

基　　金：广东省惠州市科技计划项目(2016Y97)

摘　　要：目的分析Xpert MTB/RIF方法用于临床快速检测结核分枝杆菌(MTB)与利福平耐受性的临床意义。方法收集2015年1-12月在惠州市结核病防治研究所及5个县区医院结核科就诊的肺结核患者痰标本552例,进行涂片镜检、Xpert MTB/RIF核酸检测和改良罗氏培养,并对培养阳性者进行药敏实验。评价各种方法 MTB检测灵敏度与特异度,对比传统药敏方法和Xpert MTB/RIF检测利福平耐药性的结果并分析。结果 Xpert MTB/RIF与改良罗氏培养法对MTB检测结果相比,敏感度95.3%、特异度93.1%;耐药性对比结果中,所有阳性标本中利福平耐药的敏感度82.1%,特异度97.8%;Xpert MTB/RIF检测MTB分级与改良罗氏培养分级一致性分析中,kappa=0.688,提示两者结果具有良好的一致性。结论 Xpert MTB/RIF可用于临床早期快速检测结核分枝杆菌与利福平耐药检测的筛查,有利于临床快速决策。Objective To analyzer the clinical significance of the Xpert MTB/RIF method for rapidly detecting Mycobacterium tuberculosis（MTB）and rifampicin resistance in clinic.Methods A total of 552 sputum samples were collected from the patients in the Huizhou Municipal Institute of Tuberculosis Prevention and Control and tuberculosis departments in 5counties and districts from January 2015 to December 2015.Smear microscopic examination,Xpert MTB/RIF nucleic acid detection and improved Roche culture were performed.The samples of culture positive were performed the drug susceptibility test.The sensitivity,specificity of various methods for detecting MTB were evaluated.The results of conventional susceptibility test and Xpert MTB/RIF for detecting rifampicin resistance were compared and analyzed.Results Compared with the Roche culture method,the sensitivity and specificity of Xpert MTB/RIF for detecting MTB were 95.3% and 93.1%.In the comparison of drug resistance detection results,the sensitivity and specificity of rifampicin resistance in all positive samples were 82.1% and 97.8%.In the consistency analysis of Xpert MTB/RIF and improved Roche culture for detecting MTB classification,kappa=0.688,indicating that the results of the two methods had good consistency.Conclusion The Xpert MTB/RIF method can be used in MTB early rapid detection and screening of rifampicin resistance detection,which is conducive to clinical rapid decision.

关 键 词：结核分枝杆菌 利福平 耐药 

分 类 号：R446.5[医药卫生—诊断学] R52[医药卫生—临床医学]