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GeneXpert MTB/RIF技术在结核性胸膜炎诊断及利福平耐药检测中的价值

Evaluation of GeneXpert MTB/RIF assay for diagnosis of tuberculous pleurisy and detection of rifampin resistance

摘要:

目的 探讨GeneXpert MTB/RIF技术在结核性胸膜炎诊断及利福平耐药检测中的应用价值.方法 收集住院已经确诊的结核性胸膜炎74例患者胸腔积液,采用集菌涂片法、分枝杆菌培养法和GeneXpert MTB/RIF法3种方法检测,对其阳性率进行比较;并对培养阳性菌株作比例法和基因芯片检测利福平的药敏情况,结果与GeneXpert MTB/RIF法对比.结果 74例胸腔积液集菌涂片法、分枝杆菌培养法和GeneXpert MTB/RIF法阳性率分别为14.9%、17.6%和81.1%,GeneXpert MTB/RIF法和其他2种方法比较,差异有统计学意义(P值均<0.01),且GeneXpert MTB/RIF法菌量“低”和“极低”49例,集菌涂片法抗酸分枝杆菌均为阴性.74例标本分枝杆菌培养阳性者13例,分别取其菌落用比例法和基因芯片法检测利福平均为敏感,与GeneXpert MTB/RIF法检测结果一致.结论 GeneXpert MTB/RIF技术操作简便、快速、安全,敏感性和特异性较高,对早期诊断结核性胸膜炎以及判定利福平的耐药情况具有重大价值.

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abstracts:

Objective To investigate the values of GeneXpert MTB/RIF assay for the diagnosis of tuberculous pleurisy and rifampin resistance detection.Methods 74 hospitalized patients diagnosed with tuberculous pleurisy were collected,using collecting bacteria smear,mycobacterial culture and GeneXpert MTB/RIF method to detect and compare positive rate.Rifampin resistance of culture positive strains was tested by ratio method and gene chip,and the result was compared with GeneXpert MTB/RIF method.Results The positive rates of bacteria smear,mycobacterial culture,and GeneXpert MTB/RIF method in 74 pleural effusion patients were 14.9%,17.6%,and 81.1%,there was statistical difference between GeneXpert MTB/RIF method and two other methods (both P <0.01).The amount of bacteria was "low" and "lower" in 49 cases with GeneXpert MTB/RIF,acid-fast bacilli was negative with collecting bacteria smears.13 cases were positive for mycobacterial culture method,all showed susceptibility to ratio method and gene chip method,which was consistent with GeneXpert MTB/RIF result.Conclusions GeneXpert MTB/RIF method is simple,rapid,and with high safety,sensitivity,specificity,has great value in the early diagnosis of tuberculous pleurisy and determination of rifampin resistance.

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