Xpert MTBRIF实验在结核病诊断中应用.docVIP

Xpert MTBRIF实验在结核病诊断中应用 　　[摘要] 目的 评价利福平耐药实时荧光定量核酸扩增技术（Xpert MTB/RIF）实验在结核病诊断中的检验效能。 方法 收集2014年10月～2015年5月徐州市传染病医院的237例可疑结核病患者进行结核菌检测，将患者分为结核组和非结核组，其中结核组195例，非结核组42例。两组患者均行Xpert MTB/RIF实验、T-spot实验、涂片镜检法、液体培养以及药敏实验，以临床诊断为金标准，比较各项检测的敏感性和特异性。 结果 以临床诊断为金标准，Xpert MTB/RIF实验检测结核分枝杆菌敏感性为56.9%，T-spot实验、痰涂片、液体培养敏感性依次为53.8%、26.7%、43.6%，Xpert MTB/RIF检测敏感性明显高于涂片镜检（χ2=36.691，P = 0.000）和液体培养（χ2=6.934，P = 0.008），但与T-spot实验无差别（χ2=0.347，P = 0.541）。以传统药敏实验结果作为金标准，Xpert MTB/RIF实验检测利福平耐药的敏感性和特异性分别为88.9%和98.5%。 结论 Xpert MTB/RIF实验较传统的结核病实验室诊断方法具有较好的敏感性和特异性，可作为结核病诊断的辅助手段。 　　[关键词] 结核；利福平；利福平耐药实时荧光定量核酸扩增技术 　　[中图分类号] R521 [文献标识码] A [文章编号] 1673-7210（2015）10（a）-0116-04 　　Application of Xpert MTB/RIF detection test in the diagnosis of tuberculosis 　　LIU Huimei1，2 YAN Xuebing3 　　1.Department of Medicine， Xuzhou Medical College， Jiangsu Province， Xuzhou 221000， China； 2.Department of Tuberculosis， Xuzhou Infectious Diseases Hospital， Jiangsu Province， Xuzhou 221000， China； 3.Department of Infectious Diseases， Affiliated Hospital of Xuzhou Medical College 221000， China 　　[Abstract] Objective To analyze the application value of Tuberculosis and rifampin resistance detection of Xpert MTB/RIF test. Methods From October 2014 to May 2015， 237 patients suspected tuberculosis in Xuzhou Infectious Diseases Hospital were selected， and they were divided into tuberculosis group （195 cases） and non-tuberculosis group（42 cases）. sputum samples of patients in two groups were collected to do liquid culture， smear， T-spot test， smear observed of lens and Xpert MTB/RIF test， clinical diagnosis was as the gold standard， sensitivity and specificity of every methods were ompared. Results The sensitivity of Xpert MTB/RIF， T-spot test， smear， liquid culture on testing Mycobacteria tuberculosis were 56.9%， 53.8%， 26.7%， 43.6% by clinical diagnosis as gold standard. The sensitivity of Xpert MTB/RIF was higher than smear （χ2=36.691，P = 0.000） and liquid culture （χ2=6.934， P = 0.008）， but there was no difference with