痰涂片联合痰Xpert MTB/RIF在肺结核诊治中的价值  

The value of sputum smear combined with sputum Xpert MTB/RIF in the diagnosis and treatment of pulmonary tuberculosis

作　　者：朱文艳[1] 李美朝 ZHU Wen-yan;LI Mei-zhao(Department of Infectious Disease,Tianjin Xiqing Hospital,Tianjin 300380,China)

机构地区：[1]天津市西青医院感染性疾病科,天津300380

出　　处：《中国城乡企业卫生》2022年第2期4-6,共3页Chinese Journal of Urban and Rural Enterprise Hygiene

摘　　要：目的探讨痰结核菌涂片联合痰利福平耐药实时荧光定量核酸扩增检测技术(Xpert MTB/RIF)在肺结核的早期诊断与治疗中的价值。方法选取2018年1月1日—2019年12月31日在天津市某三级结核病定点医院结核门诊经痰结核菌涂片、痰结核菌培养、痰Xpert MTB/RIF结合胸部影像等确诊的111例结核病患者的病历资料,分析比较四种检测方式的阳性率。结果检测结果阳性率排名依次为:痰结核菌培养、痰结核菌涂片联合痰Xpert MTB/RIF、痰Xpert MTB/RIF、痰结核菌涂片;痰结核菌培养阳性率为47.06%,高于痰结核菌涂片的32.43%,差异有统计学意义(χ^(2)=4.76,P<0.05);痰结核菌培养阳性率高于痰Xpert MTB/RIF,但差异无统计学意义(χ^(2)=0.62,P>0.05)。痰结核菌涂片联合痰Xpert MTB/RIF阳性率为43.37%,高于痰结核菌涂片的32.43%,但差异无统计学意义(χ^(2)=0.40,P>0.05)。结论痰结核菌涂片联合痰Xpert MTB/RIF检测阳性率高、检测时间短且可同时检测利福平耐药性,因此联合检测可快速诊断肺结核并指导用药,值得临床推广应用。Objective To explore the value of sputum tuberculosis smear combined with sputum tuberculosis bacterium(TB)rifampicin resistant real-time fluorescence quantitative detection techniques for nucleic acid amplification(Xpert MTB/RIF)in the early diagnosis and treatment of pulmonary tuberculosis.Methods From January 1,2018 to December 31,2019,111 patients with tuberculosis diagnosed by sputum smear,sputum TB culture,sputum Xpert MTB/RIF combined with chest imaging in tuberculosis clinic of a third-class tuberculosis designated hospital in Tianjin were selected.The positive rates of four detection methods were analyzed and compared.Results The positive rate of test results was ranked as follows:sputum TB culture,sputum TB smear combined with sputum Xpert MTB/RIF,sputum Xpert MTB/RIF,sputum TB smear;the positive rate of sputum TB culture was 47.06%,which was higher than 32.43%of sputum TB smear,and the difference was statistically significant(χ^(2)=4.76,P<0.05);the positive rate of sputum TB culture was higher than that of sputum Xpert MTB/RIF,but the difference was not statistically significant(χ^(2)=0.62,P>0.05);the positive rate of sputum TB smear combined with sputum Xpert MTB/RIF was 43.37%,which was higher than 32.43%in sputum TB smear,but the difference was not statistically significant(χ^(2)=0.40,P>0.05).Conclusion The positive rate of sputum TB smear combined with sputum Xpert MTB/RIF was high,the detection time was short,and rifampicin resistance could be detected at the same time.Therefore,the combined detection could quickly diagnose pulmonary tuberculosis and guide drug use,which was worthy of clinical promotion and application.

关 键 词：痰Xpert MTB/RIF 肺结核 诊断 阳性率 耐多药结核病 

分 类 号：R52[医药卫生—内科学]