摘要
目的探讨利福平耐药实时荧光定量核酸扩增(Xpert MTB/RIF)检验技术在基层医院对肺结核的诊断价值。方法选取2015年12月—2016年4月于我院呼吸内科住院疑诊为肺结核的124例患者为研究对象,收集纤维支气管镜灌洗液,进行抗酸染色及Xpert MTB/RIF检验。结果 124例疑诊肺结核的患者,46例确诊为肺结核,其中抗酸染色阳性8例,Xpert MTB/RIF阳性33例,另有5例Xpert MTB/RIF阳性患者,经临床排除肺结核诊断。纤支镜灌洗液抗酸染色及Xpert MTB/RIF检测诊断肺结核的灵敏度、特异度、阳性预测值、阴性预测值及准确度分别为17.4%、100%、100%、67.2%、69.4%;71.7%、93.6%、86.8%、84.9%、85.5%。两种检验方法受试工作曲线下面积(AUC)分别为0.574、0.798。结论 Xpert MTB/RIF检验技术辅助诊断肺结核的临床价值由优于涂片抗酸染色,在基层医院有较好的应用前景。
Objective To investigate the diagnostic value of real-time quantitative PCR （Xpert MTB/RIF） in the diagnosis of tuberculosis. Methods From December 2015 to April 2016, 124 patients suspected pulmonary tuberculosis were selected in the respiratory department of our hospital, collecting the bronehofibroscope lavage fluid, for acid fast staining and Xpert MTB/RIF test. Results Among 124 patients with suspected pulmonary tuberculosis, 46 cases were diagnosed as pulmonary tuberculosis, in which acid fast staining was positive in 8 cases, 33 eases were Xpert MTB/RIF positive, and 5 eases of Xpert MTB/RIF positive patients,the clinical diagnosis of pulmonary tuberculosis elimination. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of acid fast straining and Xpert MTB/RIF test for the diagnosis of branchofiberoscope lavage fluid were 17.4%, 100%, 100%, 67.2%, 69.4%; 71.7%, 93.6%, 86.8%, 84.9%, 85.5%, respectively. The area under the curve （AUC） of the two test methods were 0.574 and 0.798 respectively. Conclusion The clinical value of Xpert MTB/RIF technique in the diagnosis of pulmonary tuberculosis is better than that of acid fast staining,it has a good application prospect in primary hospital.
出处
《中国继续医学教育》
2017年第10期57-59,共3页
China Continuing Medical Education
关键词
肺结核
利福平
核酸扩增技术
基层医院
pulmonary tuberculosis
rifampicin
nucleic acid amplification tech
primary hospital
