摘要
目的探讨利福平耐药实时荧光定量核酸扩增(GeneXpert MTB/RIF)技术对肺结核的灵敏度与特异性。方法选取2017年8月~2019年6月我院肺科门诊收治的300例初诊肺结核可疑患者,分别进行涂片镜检、固体培养以及Xpert MTB/RIF检测,以随访后临床诊断结果作为诊断标准,比较涂片镜检、固体培养和Xpert MTB/RIF检测结核分枝杆菌的灵敏度、特异性以及准确度。结果(1)涂片镜检的灵敏度为19.67%(48/244)、特异性为22.22%(56/252)、准确度为18.94%(104/549);固体培养的灵敏度为36.03%(98/272)、特异性为27.72%(56/202)、准确度为32.49%(154/474);Xpert MTB/RIF的灵敏度为47.13%(115/244)、特异性为30.27%(56/185)、准确度为35.26%(171/485)。(2)Xpert MTB/RIF技术与固体培养的Kappa检验发现,Kappa值为0.860、0.879、0.872,均>0.75,二者一致性良好。结论Xpert MTB/RIF技术应用于肺结核诊断的灵敏度、特异性均较涂片镜检更高,与固体培养的一致性较高,其具有操作简便、检验迅速的优势,值得推广。
Objective To explore the sensitivity and specificity of Rifampicin resistant real-time fluorescence quantitative nucleic acid amplification(GeneXpert MTB/RIF)technology in detection of pulmonary tuberculosis.Methods For 300 patients who were newly diagnosed with suspected pulmonary tuberculosis and received by our Pulmonary Outpatient from August 2017 to June 2019,smear microscopy,solid culture and Xpert MTB/RIF were applied for detection respectively and the clinical diagnosis results after follow-up were taken as diagnostic criteria to compare the sensitivity,specificity and accuracy of smear microscopy,solid culture and Xpert MTB/RIF in detection of mycobacterium tuberculosis.Results(1)The sensitivity,specificity and accuracy of smear microscopy were 19.67%(48/244),22.22%(56/252)and 18.94%(104/549)respectively;the sensitivity,specificity and accuracy of solid culture were 36.03%(98/272),27.72%(56/202)and 32.49%(154/474)respectively;the sensitivity,specificity and accuracy of Xpert MTB/RIF were 47.13%(115/244),30.27%(56/185)and 35.26%(171/485)respectively.(2)The Kappa tests of Xpert MTB/RIF technology and solid culture found that Kappa=0.860,0.879,0.872,at average of 0.75,with good consistency between both methods.Conclusion The sensitivity and specificity of Xpert MTB/RIF in diagnosis of pulmonary tuberculosis were higher than smear microscopy,with high consistency with solid culture.It also possessed advantages of easy operation and rapid detection,worthy of promotion.
作者
陆善词
黄贞
张绮丽
冯健华
郭炜
LU Shanci;HUANG Zhen;ZHANG Qili;FENG Jianhua;GUO Wei(Clinical Lab of Zhongshan Second People's Hospital,Guangdong,Zhongshan 528447,China)
出处
《中国医药科学》
2020年第13期129-131,共3页
China Medicine And Pharmacy
基金
广东省中山市社会公益科技研究资金项目(2017B1040)。
