Xpert MTB/RIF、TB-IGRA法和MGIT 960液体培养法诊断结核分枝杆菌感染  

Diagnosis of Mycobacterium tuberculosis infection by Xpert MTB/RIF,TB-IGRA and MGIT 960 liquid culture method

作　　者：向丹 何霞[1] 杨静[2] 伍锡刚 白珊珊[1] 张丽林[2] XIANG Dan;HE Xia;YANG Jing;WU Xigang;BAI Shanshan;ZHANG Lilin(Department of Laboratovy,Ya'an People's Hospital,Ya'an,Sichuan 625000,China;不详)

机构地区：[1]雅安市人民医院检验科,四川雅安625000 [2]雅安市人民医院全科学科 [3]雅安市人民医院感染科

出　　处：《医学动物防制》2023年第9期846-849,854,共5页Journal of Medical Pest Control

基　　金：四川省卫生健康委员会卫生健康科研课题(19PJ155)。

摘　　要：目的 分析结核分枝杆菌/利福平耐药实时荧光定量核酸扩增检测技术(geneXpert Mycobacterium tuberculosis/Ri-fampin, Xpert MTB/RIF)、结核分枝杆菌γ-干扰素体外释放试验(tuberculosis interferon-γ release assay, TB-IGRA)法和液体分枝杆菌培养管(mycobacterium growth indicator tube, MGIT)培养法中的BACTEC MGIT 960液体培养法(简称“MGIT 960液体培养法”)诊断结核分枝杆菌感染的临床价值,为结核病的临床诊治提供依据。方法 分析2020年3月—2022年3月在雅安市某院就诊的120例疑似结核病患者临床资料,收集其痰液标本,分别采用Xpert MTB/RIF、TB-IGRA法和MGIT 960液体培养法进行检测,比较各检测方法对结核分枝杆菌感染的诊断效能。结果 病原学检测结果显示,120例疑似结核病患者最终有106例确诊,14例未确诊,阳性率为88.33%。Xpert MTB/RIF检测结果显示,阳性检出率为43.40%(46/106);TB-IGRA法检测结果显示,阳性检出率为73.58%(78/106);MGIT 960液体培养法检测结果显示,阳性检出率为36.79%(39/106)。TB-IGRA法检测的阳性检出率高于Xpert MTB/RIF和MGIT 960液体培养法(P<0.05)。TB-IGRA法检测的灵敏度、准确度、阴性预测值均高于Xpert MTB/RIF和MGIT 960液体培养法,曲线下面积大于Xpert MTB/RIF和MGIT 960液体培养法(P<0.05)。3种检测方法的特异度与阳性预测值相比,差异无统计学意义(P>0.05)。结论 TB-IGRA法检测快速简便,对结核病诊断有良好的灵敏度、准确度和阴性预测值,其诊断效能优于Xpert MTB/RIF和MGIT 960液体培养法,提示该方法可在实验室开展应用,但其结果仍需结合临床进一步分析。Objective To analyze the clinical value of Xpert MTB/RIF,TB-IGRA and MGIT 960 liquid culture methods in the diagnosis of Mycobacterium tuberculosis infection,so as to provide guidance for the clinical diagnosis and treatment of tuberculosis.Methods The clinical data of 120 patients with suspected tuberculosis who were treated in a hospital of Ya'an City from March 2020 to March 2022 were retrospectively analyzed,and their sputum samples were collected and detected by Xpert MTB/RIF,TB-IGRA and MGIT 960 liquid culture methods respectively.The diagnostic efficacy of each detection method for Mycobacterium tuberculosis infection were compared.Results The results of etiological testing showed that of all the 120 suspected tuberculosis patients,106 were confirmed and 14 were undiagnosed,with a positive rate of 88.33%.The results of Xpert MTB/RIF test showed that the positive detection rate was 43.40%(46/106).The results of TB-IGRA method showed that the positive detection rate was 73.58%(78/106).The detection results of MGIT 960 liquid culture method showed that the positive detection rate was 36.79%(39/106).The positive detection rate of TB-ICRA method was higher than that of Xpert MTB/RIF and MGIT 960 liquid culture methods(P<0.05).The sensitivity,accuracy and negative predictive value of TB-ICRA method were higher than those of Xpert MTB/RIF and MGIT 960 liquid culture methods,and the area under the curve was larger than that of Xpert MTB/RIF and MGIT 960 liquid culture methods(P<0.05).Among the specificity and positive predictive value of the three detection methods,the difference was not statistically significant(P>0.05).Conclusion The TB-IGRA method is quick and easy to detect,and has good sensitivity,accuracy and negative predictive value for the diagnosis of tuberculosis.Its diagnostic performance is better than that of Xpert MTB/RIF and MGIT 960 liquid culture methods.This indicates that the method can be used in the laboratory,but the results still need to be further analyzed in combination with clinical prac

关 键 词：结核分枝杆菌 Xpert MTB/RIF TB-IGRA法 MGIT 960液体培养法 结核病 筛查试验 

分 类 号：R378.911[医药卫生—病原生物学]