探讨GeneXperTMTB/RIF检查在结核性胸膜炎诊断中的价值  

Study on the Value of GeneXpert MTB/RIF Assay in the Diagnosis of Tuberculous Pleurisy

作　　者：李文博[1] 刘超 孙扬[1] 张海丛[1] 路延芹[3] LI Wenbo(Shijiazhuang Fifth Hospital,Hebei Shijiazhuang 050024,China)

机构地区：[1]河北省石家庄市第五医院,河北石家庄050024 [2]河北省石家庄第三医院,河北石家庄050011 [3]河北省唐山市人民医院,河北唐山630001

出　　处：《河北医学》2019年第9期1496-1499,共4页Hebei Medicine

基　　金：河北省卫生厅课题项目,(编号:20160787)

摘　　要：目的:探讨GeneXpertMTB/RIF系统检查在结核性胸膜炎诊断中的应用价值。方法:收集临床中100例高度怀疑结核性胸膜炎患者。利用抗酸染色涂片法、胸水腺苷脱氨酶(adenosine delaminate,ADA)检测法和GeneXpert MTB/RIF系统进行检测,对比三种方法检测胸腔积液标本的检出阳性率、GeneXpert MTB/RIF系统对检出结果的量级情况,并检测出标本对利福平的耐药性。结果:100例受试者中,涂片染色法、ADA方法、GeneXpert MTB/RIF系统检测的阳性检出率分别为39%、61%、71%。GeneXpert MTB/RIF系统检测的阳性检出率分别高于涂片染色、ADA染色,差异具有统计学意义;GeneXpert MTB/RIF检测更加对检测标本更为敏感;GeneXpert MTB/RIF检测标本对利福平耐药性敏感度为83.3%(10/12),特异性为95.74%(45/47)。结论:GeneXpert MTB/RIF技术是一项操作简便、安全、高效的分子生物学检测方法,对结核性胸膜炎的早期诊断和治疗具有较大价值,值得临床推广。Objective:To investigate the value of GeneXpertMTB/RIF system in the diagnosis of tuberculous pleurisy.Methods:100 cases of highly suspected tuberculous pleurisy were collected.The positive rate of pleural effusion samples detected by acid-fast staining smear method,adenosine deaminase(ADA)detection method and GeneXpert MTB/RIF system were compared.The magnitude of detection results by GeneXpert MTB/RIF system was compared,and the drug resistance of samples to rifampicin was detected.Results:Among the 50 patients in the control group,none of the three methods were detected.In the experimental group,the positive detection rates of the smear staining method,the ADA method,and the GeneXpert MTB/RIF system were 39%,61%,and 71%,respectively.The positive detection rate of GeneXpert MTB/RIF system was higher than that of smear staining and ADA staining,and the difference was statistically significant.GeneXpert MTB/RIF assay was more sensitive to the test specimens;GeneXpert MTB/RIF assay specimens were 83.3%(10/12)sensitive to rifampicin resistance and 95.74%(45/47)specific.Conclusion:GeneXpert MTB/RIF technology is a simple,safe and efficient molecular biological detection method.It has great value for the early diagnosis and treatment of tuberculous pleurisy,and it is worthy of clinical promotion.

关 键 词：结核性胸膜炎 GeneXpert MTB/RIF系统 腺苷脱氨酶检测(ADA检测) 诊断 

分 类 号：R52[医药卫生—内科学]