Xpert MTB/RIF对西部少数民族地区肺结核的诊断价值研究  

The Diagnostic Value of Xpert MTB/RIF for Pulmonary Tuberculous in Western Ethnic Minority Areas of China

作　　者：刘倩茜[1] 王永生[1] 陈云凤[1] 白云丹[1] 曾作梅 Liu Qianqian;Wang Yongsheng;Chen Yunfeng(Department of Respiratory and Critical Care Medicine,Department of Otorhinolaryngology,Chengdu First People′s Hospital,Chengdu,Sichuan 610095,China)

机构地区：[1]成都市第一人民医院呼吸与危重症医学科,耳鼻喉科,四川成都610095

出　　处：《四川医学》2022年第5期421-425,共5页Sichuan Medical Journal

基　　金：四川省科技计划项目(编号:2017SZ0143)。

摘　　要：目的探讨Xpert MTB/RIF检测技术对西部少数民族地区肺结核及耐药肺结核的诊断价值。方法选取成都市第一人民医院2017年1月至2020年12月收治的130例初诊可疑肺结核的藏族/彝族患者的呼吸道标本,分别进行抗酸杆菌涂片、改良罗氏固体培养、Xpert MTB/RIF检测以及比例法药敏实验,比较上述方法对肺结核及耐药肺结核的诊断价值。结果Xpert MTB/RIF诊断肺结核的敏感度高于改良罗氏固体培养法,显著高于涂片抗酸杆菌检查;诊断肺结核时特异度与改良罗氏固体培养法和涂片抗酸杆菌检查相当。Xpert MTB/RIF在涂片阴性肺结核患者中均具有较高诊断价值,且采用支气管肺泡灌洗液标本更具有诊断优势。结论Xpert MTB/RIF检测技术对肺结核具有较高诊断价值,适合在中国基层实验室尤其是西部少数民族地区推广。Objective To explore the diagnostic value of Xpert MTB/RIF detection technology for pulmonary tuberculosis and drug-resistant pulmonary tuberculosis in western ethnic minority areas of China.Methods A total of 130 newly diagnosed Tibetan/Yi patients with suspected pulmonary tuberculosis admitted to Chengdu First People’s Hospital and 363 Hospital from January 2017 to December 2020 were selected.The smear acid-fast bacilli test,modified Rochner solid culture test,Xpert MTB/RIF test,and drug sensitivity test using proportional method were performed respectively.The diagnostic value of the above-mentioned detection methods for pulmonary tuberculosis and drug-resistant pulmonary tuberculosis were compared.Results The sensitivity of Xpert MTB/RIF in the diagnosis of pulmonary tuberculosis was higher than that of the modified Roche solid culture method and significantly higher than that of the smear acid-fast bacilli test.The specificity of Xpert MTB/RIF in the diagnosis of pulmonary tuberculosis was equivalent to that of the modified Roche solid culture method and the smear acid-fast bacilli test.Xpert MTB/RIF had a high diagnostic value in smear negative pulmonary tuberculosis patients,and the use of bronchoalveolar lavage fluid samples had more diagnostic advantage.Conclusion Xpert MTB/RIF detection technology has a high diagnostic value for pulmonary tuberculosis.It is suitable for promotion in basic laboratories in China,especially in western ethnic minority areas.

关 键 词：Xpert MTB/RIF 肺结核 敏感度 特异度 

分 类 号：R521[医药卫生—内科学]