利福平耐药实时荧光定量核酸扩增检测技术应用于儿童肺结核快速诊断的效果  

The effect of rapid diagnosis of Xpert MTB/RIF for child pulmonary tuberculosis

作　　者：黄晴[1] HUANG Qing(Department of Tuberculosis,Wuhan Medical Treatment Center,Wuhan 430040,China)

机构地区：[1]武汉市医疗救治中心结核科,湖北武汉430040

出　　处：《实用医院临床杂志》2019年第3期148-150,共3页Practical Journal of Clinical Medicine

摘　　要：目的探讨利福平耐药实时荧光定量核酸扩增检测技术(XpertMTB/RIF)在快速诊断儿童肺结核中的应用价值。方法我院收治经临床诊断的120例肺结核患儿,采集肺泡灌洗液标本,分别行结核分枝杆菌罗氏培养、比例法药敏试验及XpertMTB/RIF检测。结果 120例灌洗液,罗氏培养显示,25例阳性,阳性率20. 83%(25/120); XpertMTB/RIF检测显示,74例阳性,阳性率61. 67%(74/120)。25例罗氏培养阳性的标本中,XpertMTB/RIF检测结核分枝杆菌阳性率为96. 00%(24/25),95例罗氏培养阴性标本中,XpertMTB/RIF检测结核分枝杆菌阳性率为52. 63%(50/95)。以比例法药敏试验结果为"金标准",XpertMTB/RIF检测利福平耐药的敏感度为100. 00%(3/3),特异度为95. 45%(21/22)。结论 XpertMTB/RIF可快速检测儿童肺泡灌洗液中结核分枝杆菌及利福平耐药情况,敏感度较高,对儿童肺结核诊疗有一定价值。Objective To investigate the application value of Xpert mycobacterium tuberculosis/rifampicin( Xpert MTB/RIF in the rapid diagnosis of child pulmonary tuberculosis. Methods One hundred and twenty children with pulmonary tuberculosis who were admitted to our hospital were enrolled in the study.The bronchoalveolar lavage fluid( BALF) specimens of all subjects were collected for Lowenstein-Jensen cultures of mycobacterium tuberculosis and drug sensitivity test by using proportion sensitivity method and Xpert MTB/RIF detection.Results Lowenstein-Jensen cultures of BALF showed that the positive rate was 20. 83%( 25/120) while Xpert MTB/RIF detection showed the positive rate was 61. 67%( 74/120).The positive rate of mycobacterium tuberculosis detected by Xpert MTB/RIF detection in 25 cases of Lowenstein-Jensen culture positive specimens was 96. 00%( 24/25) while the positive rate in95 cases of Lowenstein-Jensen culture negative specimens was 52. 63%( 50/95).The sensitivity and specificity of Xpert MTB/RIF detection for rifampin resistance were 100. 00%( 3/3) and 95. 45%( 21/22),respectively,when results of drug sensitivity test by proportion sensitivity method were taken as the golden standard.Conclusion Xpert MTB/RIF can quickly detect mycobacterium tuberculosis in BALF and rifampicin resistance in children with high sensitivity.It is of certain value in diagnosis and treatment of pulmonary tuberculosis in children.

关 键 词：核酸扩增检测技术 分枝杆菌 肺结核 儿童 快速诊断 

分 类 号：R521[医药卫生—内科学]