GeneXpert MTB/RIF系统对结核病诊断价值的回顾性分析  

Retrospective analysis of the diagnostic value of GeneXpert MTB/RIF system for tuberculosis

作　　者：陈晶[1] 丘文 苏冰[1] 胡秀梅[1] 林丽[1] 周芳[1] 肇恒瑞 芮勇宇[1] CHEN Jing;QIU Wen;SU Bing;HU Xiumei;LIN Li;ZHOU Fang;ZHAO Hengrui;RUI Yongyu(Department of Clinical Laboratory,Southern Hospital of Southern Medical University,Guangzhou,Guangdong 510515,China)

机构地区：[1]南方医科大学南方医院检验科,广东广州510515

出　　处：《检验医学与临床》2021年第21期3101-3104,3108,共5页Laboratory Medicine and Clinic

摘　　要：目的回顾性分析GeneXpert MTB/RIF结核分枝杆菌鉴定对结核病诊断的应用价值。方法收集2020年1-5月进行GeneXpert MTB/RIF结核分枝杆菌鉴定的住院患者669例,与抗酸染色镜检、结核菌素试验、结核分枝杆菌免疫球蛋白(Ig)G抗体检测、罗氏培养法、结核分枝杆菌基因(TB-DNA)扩增检测、γ-干扰素释放(IGRA)试验的检测结果进行对比分析,评估灵敏度、特异度、阳性预测值、阴性预测值等指标。结果GeneXpert MTB/RIF试验的灵敏度为53.98%,与IGRA试验(83.33%)和结核菌素试验(38.89%)比较,差异无统计学意义(P>0.05),但高于结核分枝杆菌IgG抗体检测(13.33%)、TB-DNA扩增检测(25.93%)和抗酸染色镜检(8.11%),差异有统计学意义(P<0.05)。GeneXpert MTB/RIF试验的特异度为99.64%,与罗氏培养法(100.00%)、TB-DNA扩增检测(100.00%)、抗酸染色镜检(99.64%)比较,差异无统计学意义(P>0.05),但高于IGRA试验(51.72%)、结核菌素试验(66.67%)和结核分枝杆菌IgG抗体检测(80.39%),差异有统计学意义(P<0.05)。结论GeneXpert MTB/RIF试验具有较高的灵敏度和特异度,可作为结核病确诊依据。Objective To retrospectively analyze the application value of GeneXpert MTB/RIF Mycobacterium tuberculosis identification in the diagnosis of tuberculosis.Methods A total of 669 hospitalized patients who underwent GeneXpert MTB/RIF Mycobacterium tuberculosis identification from January to May 2020 were collected.The results of acid-fast staining microscopic test,tuberculin test,Mycobacterium tuberculosis immunoglobulin(Ig)G antibody test,Roche culture method,Mycobacterium tuberculosis gene(TB-DNA)amplification test,and gamma-interferon release(IGRA)test were compared and analyzed.The sensitivity,specificity,positive predictive value and negative predictive value were evaluated.Results The sensitivity of GeneXpert MTB/RIF test was 53.98%.Compared with IGRA test(83.33%)and tuberculin test(38.89%),the differences were not statistically significant(P>0.05),but higher than that of Mycobacterium tuberculosis IgG antibody test(13.33%),TB-DNA amplification test(25.93%)and acid-fast staining microscopic test(8.11%),the differences were statistically significant(P<0.05).The specificity of GeneXpert MTB/RIF test was 99.64%.Compared with Roche culture method(100.00%),TB-DNA amplification test(100.00%),acid-fast staining microscopic test(99.64%),the differences were not statistically significant(P>0.05),but higher than IGRA test(51.72%),tuberculin test(66.67%)and Mycobacterium tuberculosis IgG antibody test(80.39%),the differences were statistically significant(P<0.05).Conclusion The GeneXpert MTB/RIF test has high sensitivity and specificity,and can be used as a basis for the diagnosis of tuberculosis.

关 键 词：GeneXpert MTB/RIF 结核病 结核分枝杆菌 

分 类 号：R521[医药卫生—内科学]