实时荧光定量核酸扩增技术在结核筛查诊断中的临床应用研究  

Clinical evaluation of GeneXpert MTB/RIF assay for screening and diagnosing tuberculosis and rifampin resistance tuberculosis

作　　者：刘喆[1] 赵强[1] 张樱[1] 王成彬[1] LIU Zhe;ZHAO Qiang;ZHANG Ying;WANG Cheng-bin(PLA General Hospital,Beijing 100853,China)

机构地区：[1]解放军总医院医学检验中心

出　　处：《中华医院感染学杂志》2019年第23期3535-3538,共4页Chinese Journal of Nosocomiology

基　　金：国家重点研发计划基金资助项目(2017YFC160150)

摘　　要：目的评价实时荧光定量核酸扩增(GeneXpert MTB/RIF)技术对呼吸道标本、组织标本、无菌体液标本等临床常见标本中结核菌和利福平耐药结核菌的筛查诊断效果。方法收集2016年1月-2017年12月解放军总医院的1015份(来自961例患者)呼吸道标本、组织标本或无菌体液标本等,采用GeneXpert MTB/RIF技术进行结核菌鉴定和耐利福平基因的检测。结果在1015份标本中,结核菌阳性82份,阳性率为8.08%,痰、肺泡灌洗液、脑脊液、胸腹水、尿、组织等标本中结核菌均有检出;82份结核菌阳性标本中利福平耐药7份,耐药率为8.54%,其中6份探针E未检出,1份探针B未检出。共有515份标本同时送检GeneXpert MTB/RIF和抗酸涂片染色两种方法,其中GeneXpert MTB/RIF阳性率9.51%,抗酸涂片检测阳性率2.72%(P<0.05)。结论GeneXpert MTB/RIF技术可用于临床常见标本中结核菌和利福平耐药结核菌的筛查诊断,且该方法快速、简便、自动化程度高,有较好的临床应用和推广价值。OBJECTIVE To evaluate the effect of GeneXpert MTB/RIF assay in detection of respiratory tract and body fluid specimen among General Hospital of PLA for diagnosing tuberculosis and Rifampin resistance tuberculosis.METHODS The 1015 samples of respiratory tract and body fluid specimens were collected from Jan 2016 to Dec 2017 from 961 patients in General Hospital of PLA.All samples were tested by GeneXpert MTB/RIF assay and rifampin resistance gene.RESULTS Totally 82 MTB specimens were positive in the 1015 samples by GeneXpert MTB/RIF assay detection and the positive rate was 8.08%.Mycobacterium tuberculosis was detected from a variety of specimens,such as sputum,alveolar washing fluid,cerebrospinal fluid,pleural effusion,urine,tissue,and etc.Rifampin resistance gene was detected in 7 samples by GeneXpert MTB/RIF assay and the rifampin resistance rates were 8.54%,of which 6/7 were Probe E undetectable and 1/7 was Probe B undetactable.A total of 515 samples were detected both by the GeneXpert MTB/RIF assay and the acid-fast staining.The positive rate of GeneXpert MTB/RIF assay was 9.51%and the acid-fast staining was 2.72(P<0.05).CONCLUSION GeneXpert MTB/RIF is an effective molecular biology assay in the detection of Mycobacterium tuberculosis and rifampin resistance,which may have good clinical promotion of application.

关 键 词：GeneXpert MTB/RIF技术 结核分枝杆菌 利福平耐药 结核病诊断 

分 类 号：R52[医药卫生—内科学]