Xpert MTB/RIF在快速诊断肺结核及利福平耐药中的诊断效能
Diagnostic efficacy of Xpert MTB/RIF in rapid diagnosis of pulmonary tuberculosis and rifampicin resistance
周玉婷 1余婷1
作者信息
- 1. 武汉市金银潭医院 湖北 武汉 430023
- 折叠
摘要
目的:探讨Xpert MTB/RIF检测在快速诊断肺结核及利福平耐药的检验效能.方法:搜集2020年5月至2023年6月在武汉市金银潭医院诊断为肺结核患者的529份痰标本及肺泡灌洗液标本,分别采用Xpert MTB/RIF检测、MGIT960培养(BACTEC MGIT960培养)法及荧光染色法检测结核分枝杆菌(MTb),分析Xpert MTB/RIF在痰和肺泡灌洗液中检测MTb的灵敏度及特异度以及利福平的耐药性.结果:以MGIT960培养法为检测MTb金标准,Xpert MTB/RIF检测MTb在痰中的灵敏度和特异度分别是83.50%(197/236)、86.69%(254/293),而在肺泡灌洗液中的灵敏度和特异度分别为94.93%(262/276)、82.21%(208/253);Xpert MTB/RIF检测在痰和支气管肺泡灌洗液中检测MTb的阳性率分别为48.2%和58.0%(P<0.05).以绝对浓度法为金标准,Xpert MTB/RIF检测利福平耐药的灵敏度为100%、特异度为99.4%.结论:Xpert MTB/RIF检测Mtb的灵敏度及特异度均较高,且肺泡灌洗液中的灵敏度高于痰标本,差异具有统计学意义,在利福平耐药的诊断方面有可靠的价值.
Abstract
Objective:To explore the efficacy of Xpert MTB/RIF detection in rapid diagnosis of pulmonary tuberculosis and rifampicin resistance.Methods:A total of 529 sputum and alveolar lavage fluid sam-ples from patients diagnosed with pulmonary tuberculosis at Jinyintan Hospital in Wuhan City from January 2018 to December 2018 were collected.Xpert MTB/RIF technology,liquid culture(BACTEC MGIT960 culture)method and fluorescence staining method were used to detect Mycobac-terium tuberculosis(MTb),respectively.The sensitivity and specificity of Xpert MTB/RIF in detect-ing MTb in sputum and alveolar lavage fluid,and the resistance to rifampicin were analyzed.The re-sults showed that using the liquid culture method as the gold standard for detecting MTb,the sensitivi-ty,and specificity of Xpert MTB/RIF for detecting MTb in sputum was 83.50%(197/236)and 86.69%(254/293),respectively;however,the sensitivity and specificity in alveolar lavage fluid were 94.93%(262/276)and 82.21%(208/253),respectively.The positive rates of detecting MTb in spu-tum and bronchoalveolar lavage fluid using Xpert MTB/RIF technology were 48.2%and 58.0%,re-spectively,with statistically significant differences between the two methods(P<0.05).Using the ab-solute concentration method as the gold standard,the sensitivity and specificity of XpertMTb/RIF technology for detecting rifampicin resistance were 100%and 99.4%,respectively.Conclusion:The sensitivity and specificity of Xpert MTB/RIF in detecting MTb are high,and the sensitivity in alveo-lar lavage fluid is higher than that in sputum samples.This method is reliable for diagnosing rifampicin resistance.
关键词
核酸扩增技术/结核分枝杆菌/肺泡灌洗液/肺结核/灵敏度/特异度/利福平Key words
Nucleic Acid Amplification Technology/Mycobacterium Tuberculosis/Alveolar Lavage Fluid/Pulmonary Tuberculosis/Sensitivity/Specificity/Rifampicin引用本文复制引用
出版年
2024
NETL
NSTL
万方数据