不同检测方法在结核病利福平耐药快速诊断中的临床应用研究  

Study on the clinical application of different detection methods in the rapid diagnosis of tuberculosis resistance to rifampicin

作　　者：包训迪[1] 王庆[1] 王舒 徐东芳[1] 梁锁 江跃 BAO Xundi;WANG Qing;WANG Shu;XU Dongfang;LIANG Suo;JIANG Yue(Department of Clinical Laboratory,Anhui Chest Hospital/Anhui Provincial Institute of Tuberculosis Prevention and Control,Hefei,Anhui 230022,China)

机构地区：[1]安徽省胸科医院/安徽省结核病防治研究所检验科,安徽合肥230022

出　　处：《检验医学与临床》2021年第18期2651-2654,共4页Laboratory Medicine and Clinic

基　　金：安徽省卫生和计划生育委员会科研计划项目(15tb011);安徽省胸科医院科研项目(2020kj018B)。

摘　　要：目的评价结核病实验室不同检测方法在结核病患者利福平(RFP)耐药快速诊断中的检测效能及应用价值。方法收集2020年1-7月在该院就诊的肺结核患者痰或肺泡灌洗液标本,采用不同检测方法进行结核分枝杆菌及RFP耐药快速检测,评价不同检测方法在结核分枝杆菌和RFP耐药快速诊断中的检测效能。结果多色熔解曲线分析(MMCA)法、Gene-Xpert法、微孔板(MIC)法检测均获得RFP药敏试验结果的有77例,77例中3种检测方法结核分枝杆菌对RFP的耐药率(38.96%、33.77%、35.06%)比较,差异均无统计学意义(P>0.05);不同性别、年龄、菌量标本的患者3种检测方法结核分枝杆菌对RFP的耐药率比较,差异均无统计学意义(P>0.05)。结论MMCA法、Gene-Xpert法和MIC法在临床上检测结核分枝杆菌对RFP的耐药性结果无明显差异,均具有较高的灵敏度和特异度,可结合临床实际需求选择药敏药检测技术。Objective To evaluate the efficacy and application value of different tuberculosis laboratory testing methods in the rapid diagnosis of rifampicin(RFP)resistance in tuberculosis patients.Methods Sputum or alveolar lavage fluid samples from pulmonary tuberculosis patients treated in the hospital from January to July 2020 were collected.Different detection methods were used for rapid detection of Mycobacterium tuberculosis and RFP resistance,and the detection efficiency of different detection methods in rapid diagnosis of Mycobacterium tuberculosis and RFP resistance was evaluated.Results The results of RFP susceptibility test were obtained by multicolor melting curve analysis(MMCA),Gene-Xpert and microplate(MIC)in 77 cases.There was no significant difference in the drug resistance rate of Mycobacterium tuberculosis to RFP(38.96%,33.77%and 35.06%)among the three detection methods(P>0.05).There was no significant difference in the drug resistance rate of Mycobacterium tuberculosis to RFP among patients with different gender,age and bacterial samples(P>0.05).Conclusion MMCA method,Gene-Xpert method and MIC method have no significant difference in the clinical detection of drug resistance of Mycobacterium tuberculosis to RFP.They all have high sensitivity and specificity.The drug sensitivity detection technology can be selected according to the actual clinical needs.

关 键 词：多色熔解曲线分析 Gene-Xpert 微孔板 肺结核 利福平 耐药 

分 类 号：R52[医药卫生—内科学]