首页|Xpert MTB/RIF联合宏基因组高通量测序对菌阴肺结核的诊断价值分析

Xpert MTB/RIF联合宏基因组高通量测序对菌阴肺结核的诊断价值分析

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目的 探讨Xpert MTB/RIF联合宏基因组高通量测序对菌阴肺结核的诊断价值.方法 回顾性分析 2019 年 12 月至2022 年 5 月诊断为菌阴肺结核的 70 例患者,分别进行Xpert MTB/RIF检测、宏基因组高通量测序及二者联合检测.采用固体培养法和比例法对生化病原菌进行诊断并分析诊断效能.采用预测值绘制受试者操作特征曲线.结果 Xpert MTB/RIF诊断阳性率 75.57%,阴性率 21.43%;宏基因组高通量测序诊断阳性率 78.57%,阴性率 21.43%;联合诊断阳性率 88.57%,阴性率 11.43%.Xpert MTB/RIF检测敏感度为 77.55%、特异性为 59.86%,曲线下面积(area under the curve,AUC)为 0.827;宏基因组高通量测序检测敏感度为 77.47%、特异性为 61.02%,AUC为 0.808;联合检测敏感度为 89.75%、特异性为 89.57%,AUC为 0.925.结果 显示Xpert MTB/RIF联合宏基因组高通量测序在菌阴肺结核中诊断的敏感度、特异性均高于单一检测(P<0.05).结论 Xpert MTB/RIF联合宏基因组高通量测序在菌阴肺结核诊断中具有较好的应用价值,值得临床推广使用.
Diagnostic value analysis of Xpert MTB/RIF combined with high-throughput metagenomic sequencing
Objective To investigate the diagnostic value of Xpert MTB/RIF combined with metagenic high-throughput sequencing in bacterial negative tuberculosis.Methods Retrospective analysis of 70 patients diagnosed with bacterial negative pulmonary tuberculosis from December 2019 to May 2022 enrolled in the study.Xpert MTB/RIF testing,high-throughput metagenomic sequencing,and a combination of the two were performed,respectively.Solid culture and proportional methods were used to diagnose biochemical pathogens and analyze diagnostic efficacy.The receiver operating characteristic curve was drawn with the predicted value.Results The positive rate of Xpert MTB/RIF diagnosis was 75.57%,and the negative rate was 21.43%.The positive rate of high-throughput sequencing for metagenomics was 78.57%,while the negative rate was 21.43%;The positive rate of combined diagnosis was 88.57%,and the negative rate was 11.43%.The detection sensitivity of Xpert MTB/RIF was 77.55%,the specificity was 59.86%,and the area under the curve(AUC)was 0.827.The sensitivity of high-throughput sequencing for metagenomes was 77.47%,the specificity was 61.02%,and the AUC was 0.808.The sensitivity of the combined detection was 89.75%,the specificity was 89.57%,and the AUC was 0.925.The results showed that the diagnostic sensitivity and specificity of Xpert MTB/RIF combined with high-throughput metagenomic sequencing in bacterial negative pulmonary tuberculosis were higher than those of single detection(P<0.05).Conclusion Xpert MTB/RIF combined with metagenic high-throughput sequencing has good application value in the diagnosis of bacterial negative pulmonary tuberculosis,and is worthy of clinical application.

Xpert MTB/RIFMetagenomic high-throughput sequencingBacterial negative pulmonary tuberculosisDiagnostic value

李红玲、余思婕、于媛媛

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舟山医院感染性疾病科,浙江舟山 316000

上海市肺科医院结核科,上海 200433

Xpert MTB/RIF 宏基因组高通量测序 菌阴肺结核 诊断价值

上海市卫生健康委科研项目

20214Y0261

2024

中国现代医生
中国医学科学院

中国现代医生

影响因子:1.571
ISSN:1673-9701
年,卷(期):2024.62(12)
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