结核分枝杆菌DNA检测在结核病中的诊断价值  

Diagnostic value of Mycobacterium tuberculosis DNA detection in tuberculosis

作　　者：张益萌 柏莹[2] 牟艳玲 ZHANG Yimeng;BAI Ying;MOU Yanling(Laboratory Department,Nanzheng District People's Hospital,Hanzhong 723102;Laboratory Department,Hanzhong Central Hospital,Hanzhong 723000;Blood Transfusion Department,Nanzheng District People's Hospital,Hanzhong 723102,China)

机构地区：[1]南郑区人民医院检验科,陕西汉中723102 [2]汉中市中心医院检验科,陕西汉中723000 [3]南郑区人民医院输血科,陕西汉中723102

出　　处：《临床医学研究与实践》2024年第21期115-118,共4页Clinical Research and Practice

摘　　要：目的研究结核分枝杆菌(MTB)DNA检测在结核病中的诊断价值。方法选取2021年10月至2022年9月南郑区人民医院收治的102例结核病患者为研究组,另取同期67例其他肺部疾病患者作为对照组。以双盲实验法采集所有患者的痰液标本,以实时荧光定量-聚合酶链式反应(RT-PCR)技术检测所有患者痰液中MTB DNA,以Xpert MTB/RIF检测实施验证性诊断。将细菌学培养结果作为金标准,比较不同检测方式对结核病的诊断效能;比较不同检测方式对肺结核及肺外结核的检出情况;比较不同检测方式对不同类型肺结核的检出情况。结果MTB DNA检测共检出结核病87例,其中3例误诊,18例漏诊;Xpert MTB/RIF检测共检出结核病62例,其中2例误诊,42例漏诊。MTB DNA检测诊断结核病的灵敏度、准确度及阴性预测值高于Xpert MTB/RIF检测(P<0.05);MTB DNA检测、Xpert MTB/RIF检测诊断结核病的特异度及阳性预测值无显著差异(P>0.05)。MTB DNA检测的肺结核检出率、肺外结核检出率高于Xpert MTB/RIF检测(P<0.05)。MTB DNA检测的继发性肺结核检出率高于Xpert MTB/RIF检测(P<0.05)。结论MTB DNA检测对结核病的诊断效能较佳,对肺结核或肺外结核的诊断价值均优于Xpert MTB/RIF检测,值得推广。Objective To study the diagnostic value of Mycobacterium tuberculosis(MTB)DNA detection in tuberculosis.Methods A total of 102 patients with tuberculosis admitted in Nanzheng District People's Hospital from October 2021 to September 2022 were selected as the study group,and 67 patients with other lung diseases during the same period were selected as the control group.Sputum samples of all patients were collected by double-blind experiment;MTB DNA in sputum of all patients was detected by real-time fluorescence quantification polymerase chain reaction(RT-PCR),confirmatory diagnosis was performed by Xpert MTB/RIF detection.The results of bacterial culture were used as the gold standard,the diagnostic efficacy of different detection methods for tuberculosis was compared;the detection of pulmonary tuberculosis and extrapulmonary tuberculosis by different detection methods was compared;the detection of different types of pulmonary tuberculosis by different detection methods was compared.Results A total of 87 cases of tuberculosis were detected by MTB DNA detection,including 3 cases of misdiagnosis and 18 cases of missed diagnosis;a total of 62 cases of tuberculosis were detected by Xpert MTB/RIF detection,including 2 cases of misdiagnosis and 42 cases of missed diagnosis.The sensitivity,accuracy and negative prediction value of MTB DNA detection in the diagnosis of tuberculosis were higher than those of Xpert MTB/RIF detection(P<0.05);there were no significant differences in the specificity and positive prediction value of MTB DNA detection and Xpert MTB/RIF detection in the diagnosis of tuberculosis(P>0.05).The pulmonary tuberculosis detection rate and extrapulmonary tuberculosis detection rate of MTB DNA detection were higher than those of Xpert MTB/RIF detection(P<0.05).The secondary pulmonary tuberculosis detection rate of MTB DNA detection was higher than that of Xpert MTB/RIF detection(P<0.05).Conclusion MTB DNA detection has better diagnostic efficacy for tuberculosis,and its diagnostic value for tuberculosis o

关 键 词：结核病 结核分枝杆菌 脱氧核糖核酸 Xpert MTB/RIF 

分 类 号：R446.5[医药卫生—诊断学]