荧光PCR探针熔解曲线技术检测痰标本MTB异烟肼耐药性的应用分析  

Application Analysis of Fluorescence PCR Probe Melting Curve Technique to Detect MTB Isoniazid Resistance in Sputum Samples

作　　者：张霖燕 ZHANG Lin-yan(Hengfeng County People’s Hospital,Jiangxi Shangrao 334300)

机构地区：[1]横峰县人民医院,江西上饶334300

出　　处：《中国医疗器械信息》2025年第4期73-75,共3页China Medical Device Information

摘　　要：目的:探究分析荧光PCR探针熔解曲线技术检测痰标本MTB异烟肼耐药性的应用效果。方法:选择2020年10月~2023年10月到横峰县人民医院接受痰涂片检查且呈阳性的痰标本结核病患者80例为观察对象,对痰标本进行分离培养,对鉴定为结核分枝杆菌(MTB)的76株菌株送上级单位做比例法药物敏感试验(DST)和在横峰县人民医院做荧光PCR探针熔解曲线技术检测,以DST试验为检测结果的“金标准”,分析荧光PCR探针熔解曲线技术检测异烟肼耐药性的敏感度、特异度和阴、阳性预测值,以此判定其对MTB异烟肼耐药性的检测价值。结果:①经DST试验的检测结果发现,在76株MTB分离株中,对异烟肼具有耐药性和敏感性的分别占56株和20株;而在荧光PCR探针熔解曲线技术检测下发现,对异烟肼具有耐药性和敏感性的分别占53株和23株;②荧光PCR探针熔解曲线技术检测痰标本MTB异烟肼耐药性的敏感度、特异度均较高,分别为94.64%(53/56)、80.00%(16/20),阳性、阴性预测值分别为92.98%(53/57)、84.21%(16/19),一致性分析结果(Kappa值)显示为0.75。结论:在检测痰标本MTB异烟肼耐药性中应用荧光PCR探针熔解曲线技术可取得较理想的检测结果,检测效能好,并且该技术检测与DST检测具有较高的一致性,这有助于为后期结核病患者的治疗提供耐药方面的参考,可增强治疗效果,继而提高患者的生命安全保障。Objective:To explore the application effect of fluorescence PCR probe melting curve technology in detecting MTB isoniazid resistance in sputum samples.Methods:80 tuberculosis patients with sputum samples were selected from Hengfeng County People’s Hospital from October 2020 to October 2023 who had received sputum smear examination and were positive.The sputum samples were isolated and cultured.76 strains identified as Mycobacterium tuberculosis(MTB)were sent to higher authorities for proportional drug sensitivity test(DST)and fluorescence PCR probe melt curve detection in Hengfeng County People’s Hospital.With DST test as the“gold standard”of detection results,the sensitivity,specificity,negative and positive predictive values of fluorescence PCR probe melt curve detection for isoniazid resistance were analyzed.In this way,the detection value of MTB isoniazid resistance was evaluated.Results:①Through DST testing,it was found that among the 76 MTB isolates,56 and 20 were resistant and sensitive to isoniazid,respectively;Under the detection of fluorescence PCR probe melting curve technology,53 strains were found to be resistant and sensitive to isoniazid,accounting for 53 and 23 strains respectively;②The sensitivity and specificity of using fluorescence PCR probe melting curve technology to detect MTB isoniazid resistance in sputum samples were high,with 94.64%(53/56)and 80.00%(16/20),respectively.The positive and negative predictive values were 92.98%(53/57)and 84.21%(16/19),respectively.The consistency analysis result(Kappa value)showed 0.75.Conclusion:The fusion curve technology of fluorescent PCR probe can achieve ideal detection results and good detection efficiency in the detection of MTB isoniazid resistance in sputum samples,and this technology has a high consistency with DST detection,which is helpful to provide reference for drug resistance in the treatment of late tuberculosis patients,enhance the treatment effect,and then improve the life safety of patients.

关 键 词：荧光PCR探针熔解曲线技术 痰标本 MTB 异烟肼 耐药性 

分 类 号：R446.5[医药卫生—诊断学]