组织Gene-xpert MTB/RIF基因检测技术在结核病诊断中的应用研究  

Application of Tissue Gene-XPERT MTB/RIF Gene Detection in the Diagnosis of Tuberculosis

作　　者：谢永平 郑美玲[1] 苏惠平[1] 陈华[1] Xie Yongping(Jiangmen Institute of Tuberculosis Prevention and Control,Jiangmen Guangdong 529000)

机构地区：[1]广东省江门市结核病防治所,广东江门529000

出　　处：《黑龙江医药》2024年第6期1274-1277,共4页Heilongjiang Medicine journal

基　　金：江门市科技计划项目(项目编号:2022YL05028)。

摘　　要：目的:探讨组织Gene-xpert MTB/RIF基因检测技术在结核病诊断中的应用价值。方法:选择2022年6月至2024年2月我院收治的130例疑似结核病患者作为研究对象,取研究对象晨间痰液样本分别进行痰涂片镜检、罗氏固体培养检测、支气管黏膜组织、胸膜组织Gene-xpert MTB/RIF基因快速检测。以罗氏固体培养检测结果为金标准,分析痰涂片镜检与不同组织Gene-xpert MTB/RIF基因快速检测对结核病诊断结果的一致性;比较不同检查方式对结核病诊断效能的差异。结果:罗氏固体培养检测发现130例疑似结核病患者中,确诊为结核病的患者共72例,非结核病患者共58例,阳性率与阴性率分别为55.38%、44.62%。Kappa检验分析结果显示,痰涂片镜检与胸膜组织Gene-xpert MTB/RIF基因快速检测对结核病的诊断结果与临床实际结果均存在一般的一致性,而支气管黏膜组织Gene-xpert MTB/RIF基因检测对结核病的诊断结果与临床实际结果有较高的一致性(Kappa值分别为0.679、0.722、0.925)。支气管黏膜组织Gene-xpert MTB/RIF基因检测对结核病的诊断效能数据明显高于胸膜组织检测与痰涂片镜检(P<0.05)。结论:支气管黏膜组织Gene-xpertMTB/RIF基因检测技术在结核病诊断中的应用更好,可为结核病的临床诊断提供更为准确的数据参考,对后续治疗方案的及早制定与实施均具有指导意义。Objective:To explore the application value of tissue Gene-XPERT MTB/RIF Gene detection in the diagnosis of tuberculosis.Methods:130 suspected TB patients admitted to our hospital from June 2022 to February 2024 were selected as the study objects.Sputum samples were collected in the morning for sputum smear microscopy,Roche solid culture detection and Gene-XPERT MTB/RIF Gene rapid detection.The consistency of sputum smear microscopy and Gene-XPERT MTB/RIF Gene rapid detection in the diagnosis of tuberculosis was analyzed using Roche solid culture test as the gold standard.To compare the efficacy of the two methods in the diagnosis of tuberculosis.Results:Among 130 suspected TB patients,72 were diagnosed with TB and 58 were non-TB patients.The positive rate and negative rate were 55.38%and 44.62%,respectively.The results of Kappa test showed that the diagnostic results of tuberculosis by sputum smear microscopy and Gene-Xpert MTB/RIF Gene rapid detection in pleural tissue were generally consistent with the actual clinical results.The results of Gene-XPERT MTB/RIF Gene detection for tuberculosis in bronchial mucosa tissues were consistent with the actual clinical results(Kappa values were 0.679,0.722 and 0.925,respectively).The diagnostic efficacy of Gene-XPERT MTB/RIF Gene detection in bronchial mucosa was significantly higher than that in pleural tissue detection and sputum smear microscopy(P<0.05).Conclusion:The application of Gene-XPERT MTB/RIF Gene detection technology in the diagnosis of tuberculosis is better,which can provide more accurate data reference for the clinical diagnosis of tuberculosis,and has guiding significance for the early formulation and implementation of follow-up treatment.

关 键 词：Gene-xpert MTB/RIF基因检测技术 痰涂片镜检 结核病 临床筛查 

分 类 号：R521[医药卫生—内科学]