Xpert MTB/RIF在早期诊断结核性脑膜炎中的临床应用价值  

Clinical value of Xpert MTB/RIF in the early diagnosis of tuberculous meningitis

作　　者：刘锐[1] 张焕[1] 陈素丽[1] 李卫红[1] 张晓光[1] 王勇[1] 安贺娟[1] 刘会[1] 

机构地区：[1]河北省胸科医院结核三科,石家庄050041

出　　处：《国际检验医学杂志》2017年第19期2660-2662,共3页International Journal of Laboratory Medicine

基　　金：河北省卫生和计划生育委员会2016年度医学科学研究课题计划项目(20160494)

摘　　要：目的探讨结核性脑膜炎/利福平耐药基因检测(Xpert MTB/RIF)在早期诊断结核性脑膜炎(TBM)中的临床应用价值。方法选取该院2015年2月至2016年12月收治的130例中枢神经系统感染患者,其中65例TBM患者作为TBM组,65例非TBM患者作为非TBM组。对所有患者的脑脊液标本分别进行结核分枝杆菌抗酸染色、罗氏固体培养以及Xpert MTB/RIF检测,比较检测结果。结果以临床诊断为金标准,Xpert MTB/RIF检测TBM的灵敏度为43.08%,特异度为100.00%;固体培养法检测TBM的灵敏度为58.46%,特异度为98.46%;抗酸染色法检测TBM的灵敏度为9.23%,特异度为100.00%。以传统比例法药敏试验结果为金标准,Xpert MTB/RIF检测利福平耐药的灵敏度为88.89%,特异度为98.35%。结论 Xpert MTB/RIF是一种检测MTB及患者是否对利福平耐药的诊断新技术,具有快速、直接、可靠、特异度高的优点。Objective To investigate the clinical value of Xpert MTB/RIF in the early diagnosis of tuberculous meningitis（TBM）.Methods Totally 130 patients with central nervous system infection in our hospital from February 2015 to December 2016 were divided into two groups,65 cases of TBM patients as the TBM group,65 cases of non TBM patients as the non TBM group.The CSF samples of all patients were respectively detected by acid fast staining,Roche solid culture and Xpert MTB/RIF assay.The test results were compared.Results With clinical diagnosis as the gold standard,the sensitivity of Xpert MTB/RIF to detection of TBM was 43.08% and specificity was 100.00%.The sensitivity of solid culture to detection of TBM was 58.46% and specificity was 98.46%.The sensitivity of acid fast staining to detection of TBM was 9.23% and specificity was 100.00%.Based on the results of drug sensitivity test of traditional proportional method,the sensitivity of Xpert MTB/RIF to detection of rifampin resistance was 88.89% and specificity was 98.35%.Conclusion Xpert MTB/RIF is a new diagnostic technique for detecting TBM and rifampin resistance in patients.It has the advantages of rapid,direct,reliable and high specificity and is worthy of clinical application.

关 键 词：Xpert MTB/RIF 结核性脑膜炎 诊断 利福平 耐药 

分 类 号：R529.3[医药卫生—内科学]