临床结核病病原体分子生物学诊断年度进展2022  

Annual progress on molecular biological diagnosis of tuberculosis 2022

作　　者：梁晨 唐神结[1] Liang Chen;Tang Shenjie(Beijing Chest Hospital,Capital Medical University,Beijing Tuberculosis and Thoracic Tumor Research Institute,Tuberculosis Clinical Medical Center,Beijing 101149,China)

机构地区：[1]首都医科大学附属北京胸科医院、北京市结核病胸部肿瘤研究所、结核病临床医学中心,北京101149

出　　处：《中华结核和呼吸杂志》2023年第2期176-182,共7页Chinese Journal of Tuberculosis and Respiratory Diseases

基　　金：北京市临床重点专科项目(20201214)。

摘　　要：结核病仍然是威胁人类健康的全球公共卫生问题,快速准确的病原体检测是实现早期诊断和有效治疗的关键。近年来,结核病的病原学诊断由传统的细菌学诊断向分子诊断扩展。近1年,具有良好诊断性能的Xper MTB/RIF Ultra技术更多被应用于非呼吸道样本的检测,Xpert XDR和二代线性探针技术为MDR-TB的早期快速准确诊断提供了更多依据;基因组测序技术也被更多开发应用于非培养物样本的检测,其检测成本和所需时间已相对降低和减少;更适合初级医疗保健中心开展的Truenat技术被更广泛应用;游离DNA检测及质谱检测等新型结核病检测技术同样不断发展,有望成为结核病及耐药结核病早期快速诊断的重要手段。本文综合2021年10月1日至2022年9月30日国内外结核病病原体分子生物学诊断的重要进展成果,评估分子生物学检测技术的优缺点及应用现状,为临床选择和应用提供重要依据。Tuberculosis(TB)continues to be a global public health issue that threatens human health,and rapid and accurate pathogen detection is the key to early diagnosis and effective treatment.In recent years,the pathogenic diagnosis of tuberculosis is expanding from traditional bacteriological diagnosis to molecular diagnosis.In the past year,Xper MTB/RIF Ultra technology with good diagnostic performance has been applied more often to the detection of non-respiratory samples,and Xpert XDR and second-generation linear probe technology provided more basis for early and accurate diagnosis of multidrug resistance;genome sequencing technology has also been developed and applied more often to the detection of non-culture sample detection,and the cost and time required for detection have been relatively reduced.Truenat technology,which is more suitable for primary care centers,is more widely used;new TB detection technologies,such as cell-free DNA testing and mass spectrometry,are also being developed and are expected to become important tools for early and rapid diagnosis of TB and drug-resistant TB.In this review,we synthesized the major research results of molecular biology diagnosis of tuberculosis around the world from 1st October 2021 to 30th September 2022,and comprehensively evaluated the advantages,disadvantages and current application of molecular biology detection technologies to provide a significant basis for clinical decision-making.

关 键 词：早期快速诊断 游离DNA 全球公共卫生 病原体检测 分子生物学诊断 细菌学诊断 病原学诊断 结核病 

分 类 号：R52[医药卫生—内科学]