GeneXpertMTB/RIF对结核病的诊断价值及复治患者群体特征研究  

The Diagnostic Value of GeneXpertMTB/RIF in Tuberculosis and the Population Characteristics of Retreated Patients

作　　者：刘乃刚[1] 高迎春[2] LIU Nai-gang;GAO Ying-chun(Department of Laboratory,Baoying County People's Hospital,Baoying 225800,Jiangsu,China;Baoying County Center for Disease Control and Prevention,Baoying 225800,Jiangsu,China)

机构地区：[1]宝应县人民医院检验科,江苏宝应225800 [2]宝应县疾病预防控制中心检验科,江苏宝应225800

出　　处：《医学信息》2023年第6期134-138,共5页Journal of Medical Information

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(GeneXpertMTB/RIF)对结核病的诊断价值及复治患者群体特征研究。方法选取2021年6月-2022年1月在宝应县人民医院诊治的126例疑似结核病患者,均进行痰涂片染色、改良罗氏培养法、GeneXpertMTB/RIF检测,观察不同检测方法对结核病诊断效能、分枝杆菌利福平药敏性以及复治患者群体特征。结果GeneXpertMTB/RIF检测阳性率高于痰涂片染色、改良罗氏培养法检测阳性率(P<0.05);痰涂片染色+改良罗氏培养法+GeneXpertMTB/RIF联合检测敏感度均高于GeneXpertMTB/RIF、痰涂片染色、改良罗氏培养法单独检测,特异度小于改良罗氏培养法GeneXpertMTB/RIF、痰涂片染色,且GeneXpertMTB/RIF特异度小于改良罗氏培养法(P<0.05);GeneXpertMTB/RIF检测利福平结核分枝杆菌药敏结果与改良罗氏培养法结果一致性良好(Kappa=0.722,P<0.05);单因素分析显示,不同地区、职业、结核病接触史、治疗前症状和体征评分、既往治疗次数、既往用药种类、既往用药不良反应比较,差异有统计学意义(P<0.05),而不同年龄、性别比较,差异无统计学意义(P>0.05);多因素Logistic回归分析,农村、农民、治疗前症状及体征评分≥6分、既往治疗>2次是复治患者发生的独立危险因素(P<0.05)。结论GeneXpertMTB/RIF对结核病具有较高的诊断价值,且评估结核分枝杆菌的利福平敏感性一致性较好。结核病复治患者具有一定的群体特征,职业以农民为主,地域主要分布于农村,且服药不规律、既往治疗次数>2次,临床可结合复治结核患者群特征,给予针对性防控,从而降低结核病复治发生率。Objective To analyze the diagnostic value of rifampicin resistance real-time fluorescence quantitative nucleic acid amplification detection technology(GeneXpertMTB/RIF)for tuberculosis and the population characteristics of retreated patients.Methods From June 2021 to January 2022,126 suspected tuberculosis patients diagnosed and treated in Baoying County People's Hospital were selected for sputum smear staining,modified Roche culture method and GeneXpertMTB/RIF detection.The diagnostic efficacy of different detection methods for tuberculosis,drug sensitivity of mycobacterium rifampicin and group characteristics of retreated patients were observed.Results The positive rate of GeneXpertMTB/RIF was higher than that of sputum smear staining and modified Roche culture(P<0.05).The sensitivity of combined detection of sputum smear staining+modified Roche culture+GeneXpertMTB/RIF was higher than that of GeneXpertMTB/RIF,sputum smear staining and modified Roche culture alone,and the specificity was less than that of GeneXpertMTB/RIF and sputum smear staining of modified Roche culture,and the specificity of GeneXpertMTB/RIF was less than that of modified Roche culture(P<0.05).The results of GeneXpertMTB/RIF were consistent with those of modified Roche culture method(Kappa=0.722,P<0.05).Univariate analysis showed that there were statistically significant differences in different regions,occupations,history of tuberculosis exposure,scores of symptoms and signs before treatment,times of previous treatment,types of previous medication,and adverse drug reactions(P<0.05);there was no significant difference in age and gender(P>0.05).Multivariate logistic regression analysis showed that rural areas,farmers,pre-treatment symptoms and signs score≥6 scores,and previous treatment>2 times were independent risk factors for retreated patients(P<0.05).Conclusion GeneXpertMTB/RIF has a high diagnostic value for tuberculosis,and the consistency of rifampicin sensitivity of Mycobacterium tuberculosis is good.The retreatment tuberculosis pa

关 键 词：GeneXpertMTB/RIF 结核病 诊断价值 复治患者 群体特征 

分 类 号：R52[医药卫生—内科学]