摘要
目的评价脑脊液利福平耐药实时荧光定量核酸扩增检测技术(GeneXpert MTB/RIF)及脑脊液环介导等温扩增技术(LAMP)在结核性脑膜炎中的诊断价值。方法收集临床诊断为结核性脑膜炎住院患者110例,随机收集60例为结核性脑膜炎A组,50例为结核性脑膜炎B组,另收集其他中枢神经系统感染患者脑脊液20例为对照组(CG组)。其中结核性脑膜炎A组患者入院后抽取脑脊液送脑脊液常规、生化、结核菌涂片、结核菌培养、GeneXpert MTB/RIF,结核性脑膜炎B组患者送脑脊液作常规、生化、结核菌涂片、结核菌培养和LAMP,CG组患者送脑脊液作常规、生化、结核菌涂片、结核菌培养、GeneXpert MTB/RIF和LAMP。结果结核性脑膜炎A组脑脊液GeneXpert MTB/RIF阳性32例,其中利福平耐药基因检测阳性3例,结核性脑膜炎A组脑脊液结核菌涂片、培养、GeneXpert MTB/RIF阳性率分别为8.3%(5/60)、16.7%(10/60)和53.0%(32/60)。结核性脑膜炎B组50例脑脊液结核菌涂片、结核菌培养、LAMP,阳性率分别为8.0%(4/50),18.0%(9/50)和58.0%(29/50),CG组脑脊液GeneXpert MTB/RIF和脑脊液LAMP均为阴性。结论脑脊液GeneXpert MTB/RIF及脑脊液LAMP均为早期诊断结核性脑膜炎的较好方法。
Objective To investigate the diagnostic value of cerebrospinal fluid GeneXpert MTB/RIF and cerebrospinal fluid LAMP for tuberculous meningitis.Methods Selected 110 cases of tuberculous meningitis in patients who were diagnosed and treated,60 patients were treated as tuberculous meningitis group A randomly,50 patients were used as tuberculous meningitis group B,in addition,20 patients with another central nervous system infection were collected as control group,Group A were extracted cerebrospinal fluid in order to send cerebrospinal fluid routine,biochemical,tuberculous smear,GeneXpert MTB/RIF,Group B take cerebrospinal fluid routine,biochemical,tuberculous smear,tuberculous culture and LAMP,and cerebrospinal fluid routine,biochemical,tuberculous smear,tuberculous culture,GeneXpert MTB/RIF and LAMP were taken from control group.Results In the group A,32 patients were positive in cerebrospinal GeneXpert MTB/RIF,the cerebrospinal fluid GeneXpert MTB/RIF lifampin resistance gene was positive in 3 patients,5 patients were positive in cerebrospinal tuberculous smear with positive rate was 8.3%,10 patients were positive in cerebrospinal fluid tuberculous culture,and the posi⁃tive rate was 16.7%,32 patients were diagnosed with cerebrospinal fluid GeneXpert MTB/RIF lead to 53.0%posi⁃tive rate,In the group B,the positive rates of cerebrospinal fluid tuberculous smear,tuberculous culture and LAMP were 8.0%,18.0%and 58.0%,respectively.In the control group,patients had negative result in cerebrospi⁃nal fluid tuberculous smear,tuberculous culture,GeneXpert MTB/RIF and LAMP.Conclusions Cerebrospinal fluid GeneXpert MTB/RIF and LAMP are good methods for early diagnosis of tuberculous meningitis.
作者
冉燕
赵建军
张建勇
宗兆婧
RAN Yan;ZHAO Jianjun;ZHANG Jianyong;ZONG Zhaojing(Tuberculosis Ward,the Department of Respiratory and Critical Care Medicine,the Affiliated Hospital of Zunyi Medical University,Zunyi 563003,China)
出处
《实用医学杂志》
CAS
北大核心
2020年第24期3416-3419,共4页
The Journal of Practical Medicine
基金
贵州省科学技术厅课题(编号:黔科合LH字[2016]7487号)。
