基因芯片技术对非结核分枝杆菌肺病的诊断价值  

Value of deoxyribonucleic acid microarray and chip technology in diagnosing pulmonary disease caused by non-tuberculous mycobacterium

作　　者：刘耐 邢宝春 冷霞 赵悦[3] Liu Nai;Xing Baochun;Leng Xia;Zhao Yue(Department of Tuberculosis Fifth Ward,Henan Provincial Chest Hospital,Zhengzhou 450000,China;Depart-ment of Tuberculosis Third Ward,Henan Provincial Chest Hospital,Zhengzhou 450000,China;Clinical Labo-ratory,Henan Provincial Chest Hospital,Zhengzhou 450000,China)

机构地区：[1]河南省胸科医院结核内五科,郑州450000 [2]河南省胸科医院结核内三科,郑州450000 [3]河南省胸科医院检验科,郑州450000

出　　处：《实用医技杂志》2022年第11期1147-1150,共4页Journal of Practical Medical Techniques

摘　　要：目的探讨基因芯片法对非结核分枝杆菌(NTM)肺病的诊断价值。方法选择河南省胸科医院2020年9月至2021年3月收治的高度疑似肺结核患者200例进行回顾性分析。200例患者均行荧光支气管镜,同时采取管镜下灌洗液标本,对灌洗液标本进行基因芯片检测。以MGIT 960液体培养[对硝基苯甲酸(PNB)]为参照,分析基因芯片方法对NTM检测的敏感度、特异度和检测结果。结果200例患者中,基因芯片法鉴定出NTM阳性22例(11.0%),结核分枝杆菌复合群(MTC)阳性154例(77.0%),MTC阴性24例(12.0%)。其中22例NTM中,11例胞内分枝杆菌病(50.0%),9例脓肿分枝杆菌病(40.9%),1例堪萨斯分枝杆菌(4.5%),1例鸟分枝杆菌(4.5%);MGIT960液体培养(PNB)培养出NTM 23例(11.5%),MTC 152例(76.0%),阴性25例(12.5%)。以MGIT 960液体培养试验结果为参考标准,基因芯片法检测出NTM的敏感度为86.9%(20/23),特异度为98.9%(175/177),两者有较高一致性。而基因芯片可以分出菌型,所用时间更短。结论基因芯片技术在NTM的诊断中价值较大,有高度敏感度及特异度,用时短,有助于较早确诊,值得在临床上推广。Objective To determine the value of Deoxyribonucleic acid(DNA)microarray and chip tec-hniques in diagnosing pulmonary disease caused by non-tuberculous mycobacterium(NTM).Methods Retro-spectively included in this study were 200 patients admitted between September 2020 and March 2021 to our hospital and highly suspected to have lung tuberculosis.These 200 patients underwent fluoresence bronchoscopy,during which,specimens of lavage fluid were harvested for DNA microarray.Using findings of the liquid culture-based p-nitrobenzoic acid(PNB)test on MGIT 960 system as reference,we evaluated the results of DNA micro-array test for NTM in terms of its sensitivity and specificity.Results Among the 200 patients,DNA microarray identified 22(11.0%)positive for NTM,154(77.0%)positive for Mycobacterium tuberculosis complex(MTC),and 24(12.0%)negative for the both.Among the 22 patients positive for NTM,M.intracellulare was detected in 11(50.0%),M.abscessus in 9(40.9%),M.kansasii in 1(4.5%),and M.avium in another(4.5%).By liquid culture-based PNB test on Mycobacteria growth indicator tube(MGIT)960 system,23 patients(11.5%)were positive for NTM,152(76.0%)positive for MTC,and the remaining 25(12.5%)were dual negative.With find-ings of MGIT 960 liquid culture-based PNB test as reference,the DNA microarray testing for NTM yielded a sen-sitivity of 86.9%(20/23)and a specificity of 98.9%(175/177)leading to a high coincidence between the both tests.Yet the DNA microarray was capable of strains differentiation and less time-consuming.Conclusion Use of DNA microarray and chip techniques can be more valuable in diagnosing NTM with high sensitivity and speci-ficity over a shorter time.These advantages help confirm the diagnosis earlier and therefore warrants wi-despread use in clinical setting.

关 键 词：基因芯片技术 非结核分枝杆菌病 气管镜灌洗液 液体培养菌型鉴定 

分 类 号：R521[医药卫生—内科学]