MGIT 960培养联合GeneXpert MTB/RIF检测在泌尿系结核诊断中的价值  

Value of MGIT 960 culture combined with GeneXpert MTB/RIF detection in diagnosis of urinary tuberculosis

作　　者：李静 赵涛 梁亚萍 仵倩红 LI Jing;ZHAO Tao;LIANG Yaping;WU Qianhong(Shaanxi Provincial Tuberculosis Control Hospital,Xi’an 710100,China)

机构地区：[1]陕西省结核病防治院,陕西西安710100

出　　处：《陕西医学杂志》2021年第11期1441-1445,共5页Shaanxi Medical Journal

基　　金：陕西省卫生科研项目(2014D9)。

摘　　要：目的:评价MGIT 960培养联合GeneXpert MTB/RIF检测对泌尿系结核(UTB)的诊断价值。方法:回顾性分析185例疑似泌尿结核患者尿液标本的实验室检测资料,纳入患者为同时采用抗酸杆菌(AFB)涂片镜检(AFB涂片)、BECTEC MGIT 960液体培养(MGIT 960培养)和GeneXpert MTB/RIF(GeneXpert)检测的112例疑似UTB患者,其中确诊UTB患者62例、非UTB患者50例。以临床确诊UTB患者为参考标准评价AFB涂片、MGIT 960培养、GeneXpert检测和MGIT 960培养联合GeneXpert检测对UTB的诊断效能。结果:AFB涂片、MGIT 960培养、GeneXpert检测和MGIT 960培养联合GeneXpert检测的敏感度分别为12.9%(8/62),29.0%(18/62),53.2%(33/62)和72.6%(45/62);特异度分别为96.0%(48/50),100.0%(50/50),100.0%(50/50)和100.0%(50/50);符合率分别为50.0%(56/112),60.7%(68/112),74.1%(83/112)和84.8%(95/112)。结论:AFB涂片、MGIT 960培养尿液结核分枝杆菌的敏感度较低,GeneXpert检测尿液结核分枝杆菌的敏感度高,而MGIT 960培养联合GeneXpert检测在诊断UTB时的敏感度更高。Objective:To evaluate the diagnostic value of MGIT 960 culture combined with GeneXpert MTB/RIF detection in diagnosis of urinary tuberculosis(UTB).Methods:A retrospective analysis of the laboratory test data of 185 suspected urinary tuberculosis patients with urine specimens was included.The included patients were 112 suspected UTB patients whose urine specimens were simultaneously detected by acid-fast bacilli(AFB)smear microscopy(AFB smear),BECTEC MGIT 960 liquid culture(MGIT 960 culture)and GeneXpert MTB/RIF(Gene Xpert)testing,including 62 confirmed UTB patients and 50 non-UTB patients.The diagnostic efficacy of AFB smear,MGIT 960 culture,GeneXpert,and MGIT 960 culture combined with Gene Xpert detection on UTB was evaluated,with clinically confirmed UTB patients as the reference standard.Results:The sensitivity of AFB smear,MGIT 960 culture,GeneXpert,and MGIT 960 culture combined with GeneXpert detection was 12.9%(8/62),29.0%(18/62),53.2%(33/62)and 72.6%(45/62),respectively;the specificity was 96.0%(48/50),100.0%(50/50),100.0%(50/50)and 100.0%(50/50),respectively;the coincidence rate were 50.0%(56/112),60.7%(68/112),74.1%(83/112)and 84.8%(95/112),respectively.Conclusion:AFB smear and MGIT 960 culture are less sensitive to urine mycobacterium tuberculosis,GeneXpert detection is highly sensitive to urine mycobacterium tuberculosis,while MGIT 960 culture combined with GeneXpert detection is more sensitive in the diagnosis of UTB.

关 键 词：泌尿结核 诊断 尿液 GeneXpert检测 分枝杆菌培养 抗酸杆菌涂片镜检 

分 类 号：R527[医药卫生—内科学]