Xpert结核分枝杆菌/利福平检测诊断肺结核和检查结核分枝杆菌利福平耐药性的应用价值分析  

Analysis of Application Value of Xpert Mycobacterium Tuberculosis/Rifampicin Assay for Diagnosis of Pulmonary Tuberculosis and Detection of Mycobacterium Tuberculosis Resistance to Rifampicin

作　　者：苏玉桂 梁越媚 欧阳锦仪 左雪兵 徐汝洪 Su Yugui;Liang Yuemei;Ouyang Jinyi;Zuo Xuebing;Xu Ruhong(Department of Clinical Laboratory,The Ninth People's Hospital of Dongguan,Dongguan 523000,Guangdong Province,China;Guangzhou KingMed Centre for Clinical Laboratory,Guangzhou 510330,Guangdong Province,China;Department of Respiratory,The Ninth People's Hospital of Dongguan,Dongguan 523000,Guangdong Province,China)

机构地区：[1]东莞市第九人民医院检验科,广东东莞523000 [2]广州金域医学检验中心,广东广州510330 [3]东莞市第九人民医院呼吸科,广东东莞523000

出　　处：《中国社区医师》2024年第33期116-118,共3页Chinese Community Doctors

基　　金：东莞市社会发展科技(重点)项目(编号:20221800905442)。

摘　　要：目的:分析Xpert结核分枝杆菌/利福平检测(GeneXpert MTB/RIF)诊断肺结核和检测结核分枝杆菌利福平耐药性的应用价值。方法:选取2023年1月—2024年3月东莞市第九人民医院收治的疑似肺结核患者104例作为研究对象,进行痰涂片抗酸染色、结核分枝杆菌痰培养、比例法药敏试验、GeneXpert MTB/RIF检测,以结核分枝杆菌痰培养结果为“金标准”,比较痰涂片抗酸染色、GeneXpert MTB/RIF检测对肺结核的诊断效能,以比例法药敏试验结果为“金标准”,分析GeneXpert MTB/RIF检测结核分枝杆菌利福平耐药性的效能。结果:GeneXpert MTB/RIF诊断肺结核的准确度、灵敏度高于痰涂片抗酸染色(P<0.05);GeneXpert MTB/RIF和痰涂片抗酸染色诊断肺结核的特异度比较,差异无统计学意义(P>0.05)。GeneXpert MTB/RIF检测结核分枝杆菌利福平耐药性的准确度为97.78%(46/47),特异度为100.00%(42/42),灵敏度为80.00%(4/5)。结论:GeneXpert MTB/RIF诊断肺结核和检测结核分枝杆菌利福平耐药性的应用价值较高,可为肺结核的早期诊断及治疗提供诊断依据。Objective:To analyze the application value of Xpert mycobacterium tuberculosis/rifampicin assay(GeneXpert MTB/RIF)for diagnosis of pulmonary tuberculosis and detection of mycobacterium tuberculosis resistance to rifampicin.Methods:A total of 104 patients with suspected pulmonary tuberculosis admitted to the Ninth People's Hospital of Dongguan from January 2023 to March 2024 were selected as the study subjects.They underwent acid-fast staining of sputum smear,sputum culture of mycobacterium tuberculosis,proportion method for drug susceptible test and GeneXpert MTB/RIF assay.The sputum culture results of mycobacterium tuberculosis were used as the"gold standard"to compare the diagnostic efficacy of acid-fast staining of sputum smear and GeneXpert MTB/RIF assay for pulmonary tuberculosis.The proportion method for drug susceptible test was used as the"gold standard"to analyze the efficacy of GeneXpert MTB/RIF in detecting mycobacterium tuberculosis resistance to rifampicin.Results:The accuracy and sensitivity of GeneXpert MTB/RIF in the diagnosis of pulmonary tuberculosis were higher than those of acid-fast staining of sputum smear(P<0.05).There was no significant difference in the specificity of GeneXpert MTB/RIF and acid-fast staining of sputum smear in the diagnosis of pulmonary tuberculosis(P>0.05).The accuracy,specificity and sensitivity of GeneXpert MTB/RIF in the detection of mycobacterium tuberculosis resistance to rifampicin was 97.78%(46/47),100.00%(42/42)and 80.00%(4/5),respectively.Conclusion:GeneXpert MTB/RIF has high application value in the diagnosis of pulmonary tuberculosis and the detection of mycobacterium tuberculosis resistance to rifampicin,and can provide a diagnostic basis for the early diagnosis and treatment of pulmonary tuberculosis.

关 键 词：肺结核 结核分枝杆菌 利福平 耐药 

分 类 号：R446[医药卫生—诊断学]