利福平耐药实时荧光定量核酸扩增检测技术对结核病的诊断价值  

Diagnostic value of GeneXpertMTB/RIF assay in tuberculosis

作　　者：赵文 王震宇[1] 宋涛 Zhao Wen;Wang Zhenyu;Song Tao(School of Medicine,Wuhan University of Science and Technology,Hubei 430065,China;Department of Laboratory,Xiangyang First People's Hospital,Hubei 430065,China)

机构地区：[1]武汉科技大学医学院,430065 [2]湖北省襄阳市第一人民医院医学检验科,441000

出　　处：《实用医技杂志》2022年第9期920-923,共4页Journal of Practical Medical Techniques

摘　　要：目的 分析利福平耐药实时荧光定量核酸扩增检测技术(GeneXpert MTB/RIF)对结核病诊断的应用价值。方法 以襄阳市第一人民医院2021年1月至12月的609例疑似结核病的临床样本作研究对象。进行GeneXpertMTB/RIF分析、分离培养鉴定、抗酸涂片染色镜检、结核分枝杆菌基因(TB-DNA)扩增检测,以临床确诊结果为金标准,比较4种方法检测结核分枝杆菌的敏感度、特异度、阳性预测值、阴性预测值。结果 GeneXpertMTB/RIF检测的敏感度79.7%、特异度99.3%、阳性预测值98.3%和阴性预测值91.0%。GeneXpertMTB/RIF检测结核分枝杆菌检出率高于直接涂片染色镜检,差异有统计学意义(P<0.05)。敏感度GeneXpertMTB/RIF技术与分离培养法相比,差异无统计学意义(P>0.05),与TB-DNA扩增检测、抗酸染色涂片镜检相比差异均有统计学意义(P<0.05),GeneXpertMTB/RIF技术的敏感度高于TB-DNA技术和抗酸染色技术。特异度GeneXpertMTB/RIF技术与其他三种相比差异均无统计学意义(P>0.05)。结论 GeneXpertMTB/RIF技术有较好的敏感度和特异度,可作为结核病诊断依据。Objective To determine the diagnostic value of GeneXpertMTB/RIF assay in tuberculosis.Methods A total of 609 clinical specimens from patients with suspected tuberculosis between January 2021 and December 2021 in Xiangyang First people′ s Hospital were included in this study and subjected to GeneXpertMTB/RIF assay, bacteria isolation, culture and identification, smear microscopy with acid-fast bacilli staining,and amplification of Mycobacterium tuberculosis gene(TB-DNA). Using clinically confirmed findings as the gold standard,we compared the sensitivity,specificity,positive predictive value,and negative predictive value of these four detection methods for Mycobacterium tuberculosis. Results The sensitivity, specificity,positive and negative predictive values of GeneXpertMTB/RIF assay were 79.7%,99.3%,98.3% and 91.0%,respectively.The detection rate of Mycobacterium tuberculosis by GeneXpertMTB/RIF assay exceeded that by direct-stained smear microscopy,with statistically significant difference(P<0.05). The sensitivity of GeneXpertMTB/RIF assay did not differ significantly compared with bacteria isolation and culture(P>0.05),but varied with that by TBDNA amplification and smear microscopy with acid-fast staining. The sensitivity of GeneXpertMTB/RIF assay was significantly higher than that of TB-DNA technique and smear microscopy with acid-fast staining. There was no significant difference in specificity when comparing GeneXpertMTB/RIF assay with the other three detection methods(P>0.05). Conclusion GeneXpertMTB/RIF assay may offer satisfactory sensitivity and specificity that justifies its use as a reference for tuberculosis diagnosis.

关 键 词：结核分枝杆菌 利福平 核酸扩增检测技术 广泛耐药结核病 

分 类 号：R52[医药卫生—内科学] R440[医药卫生—临床医学]