GeneXpert MTB/RIF检测粪便标本对肠结核的早期诊断价值分析  

Analysis of the value of GeneXpert MTB/RIF in the early diagnosis of intestinal tuberculosis

作　　者：雷毅娜 陈秋悦 LEI Yi-na;CHEN Qiu-yue(Guiyang Public Health Treatment Center,Guiyang 550000,China)

机构地区：[1]贵阳市公共卫生救治中心,550000

出　　处：《中国实用医药》2024年第23期76-78,共3页China Practical Medicine

基　　金：贵阳市科技计划项目(项目编号:[2022]-4-9-1号)项目名称:GeneXpert MTB/RIF在腹腔结核诊断及利福平耐药检测应用价值的研究。

摘　　要：目的研究在肠结核早期诊断中采取结核分枝杆菌/利福平耐药实时荧光定量核酸扩增检测技术(GeneXpert MTB/RIF)检测粪便标本的参考价值与指导作用。方法选择909例疑似肠结核患者为研究对象,留取所有患者的粪便标本,并分别实施抗酸杆菌涂片检查与GeneXpert MTB/RIF检测。以临床综合诊断结果为金标准,对比GeneXpert MTB/RIF检测与抗酸杆菌涂片检查的假阳性率、诊断效能。结果909例患者经过临床综合诊断,其中阳性132例(14.52%),阴性777例(85.48%)。GeneXpert MTB/RIF检测出133例阳性,其中3例为假阳性,假阳性率为2.26%(3/133);抗酸杆菌涂片检查出136例阳性,其中34例为假阳性,假阳性率为25.00%(34/136)。GeneXpert MTB/RIF检测的假阳性率低于抗酸杆菌涂片检查,差异具有统计学意义(P<0.05)。GeneXpert MTB/RIF检测的诊断准确率、特异度、灵敏度分别为99.45%(904/909)、99.61%(774/777)、98.48%(130/132),抗酸杆菌涂片检查的诊断准确率、特异度、灵敏度分别为92.96%(845/909)、95.62%(743/777)、77.27%(102/132)。GeneXpert MTB/RIF检测的诊断准确率、特异度以及灵敏度均高于抗酸杆菌涂片检查,差异具有统计学意义(P<0.05)。结论肠结核的早期诊断中使用GeneXpert MTB/RIF检测粪便标本有较高的检验价值,值得推广与应用。Objective To study the reference value and guiding role of using GeneXpert Mycobacterium tuberculosis/Ri-fampin(GeneXpert MTB/RIF)to detect fecal samples in the early diagnosis of intestinal tuberculosis.Methods A total of 909 patients with suspected intestinal tuberculosis were selected as the research subjects.Stool samples from all patients were collected,and acid-fast bacillus smear test and GeneXpert MTB/RIF test were performed,respectively.With clinical comprehensive diagnosis results as the gold standard,the false positive rate and diagnostic efficiency of GeneXpert MTB/RIF detection and acid-fast bacillus smear test were compared.Results 909 patients were clinically diagnosed,of which 132 cases(14.52%)were positive and 777 cases(85.48%)were negative.GeneXpert MTB/RIF detected 133 positive cases,of which 3 cases were false positive,with a false positive rate of 2.26%(3/133);acid-fast bacillus smear test detected 136 positive cases,of which 34 cases were false-positive,with a false positive rate of 25.00%(34/136).The false-positive rate of GeneXpert MTB/RIF test was lower than that of acid-fast bacillus smear test,and the difference was statistically significant(P<0.05).The diagnostic accuracy,specificity and sensitivity of GeneXpert MTB/RIF detection were 99.45%(904/909),99.61%(774/777)and 98.48%(130/132);the diagnostic accuracy,specificity and sensitivity of acid-fast bacillus smear test were 92.96%(845/909),95.62%(743/777)and 77.27%(102/132).The diagnostic accuracy,specificity and sensitivity of GeneXpert MTB/RIF detection were higher than those of acid-fast bacillus smear test,and the difference was statistically significant(P<0.05).Conclusion In the early diagnosis of intestinal tuberculosis,the use of GeneXpert MTB/RIF to detect fecal samples has a high value,and is worthy of promotion and application.

关 键 词：粪便标本 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肠结核 早期诊断 价值 

分 类 号：R524[医药卫生—内科学]