摘要
目的探讨利福平耐药实时荧光定量核酸扩增技术(rfampicin resistant real-time fluorescent quantitative nucleic acid amplification,GeneXpert MTB/RIF)联合基因芯片技术在涂阴结核分支杆菌(Mycobacterium tuberculosis,MTB)诊断中的价值及血清可溶性髓系细胞触发受体-1(serum soluble triggering receptor-1,sTREM-1)、降钙素原(procalcitonin,PCT)水平的意义。方法选取2019年1月至2021年1月在聊城市人民医院就诊的疑似涂阴肺结核患者130例,采集肺泡灌洗液,给予GeneXpert MTB/RIF、基因芯片及药敏试验检查,同时检查肺结核患者血清sTREM-1、PCT水平。以肺泡灌洗液结核菌培养及药敏试验为金标准评价GeneXpert MTB/RIF联合基因芯片检测对涂阴肺结核的诊断价值。采用ROC评价血清sTREM-1、PCT对涂阴肺结核的诊断价值。结果以肺泡灌洗液结核菌培养诊断出非涂阴肺结核患者58例,涂阴肺结核患者72例。GeneXpert MTB/RIF联合基因芯片诊断肺结核的灵敏性为68.06%,高于基因芯片单独诊断(P<0.05),GeneXpert MTB/RIF联合基因芯片诊断肺结核的特异性、准确性、阳性预测值和阴性预测值分别为91.38%、78.46%、90.74%和69.74%,与GeneXpert MTB/RIF诊断、基因芯片单独诊断比较差异无统计学意义(P>0.05);GeneXpert MTB/RIF联合基因芯片诊断MDR-TB的灵敏性、特异性、准确性、阳性预测值和阴性预测值分别为94.12%、85.45%、87.50%、66.67%和97.92%,与GeneXpert MTB/RIF诊断基因芯片单独诊断比较差异无统计学意义(P>0.05);重症肺结核患者血清sTREM-1、PCT分别为(18.04±2.07)ng/ml和(2.09±0.19)ng/ml,明显高于轻症肺结核患者(P<0.05);血清sTREM-1、PCT预测重症肺结核的ROC曲线下面积分别为0.811和0.844,截断值分别为16.32 ng/ml和2.00 ng/ml,灵敏性分别为89.30%和82.00%,特异性分别为61.40%和79.60%。结论GeneXpert联合基因芯片技术可提高涂阴MTB诊断灵敏性,且两种手段对MDR-TB均有较好的诊断价值。重症肺�
ObjectiveTo investigate the value of rifampicin resistant real-time fluorescent quantitative nucleic acid amplification technology(GeneXpert MTB/RIF)combined with the gene chip technology in the diagnosis of smear-negative Mycobacterium tuberculosis(MTB)and the clinical significance of serum soluble triggering receptor-1(sTREM-1)and procalcitonin(PCT)levels in pulmonary tuberculosis.MethodsA total of 130 cases of suspected smear-negative pulmonary tuberculosis patients in Liaocheng People's Hospital from January 2019 to January 2021 were selected.Alveolar lavage fluid were collected,GeneXpert MTB/RIF were performed,gene chip method were applied,and the serum levels of sTREM-1 and PCT were detected.The alveolar lavage fluid tuberculosis culture method and the drug sensitivity test were used as the gold standard to evaluate the diagnostic value of GeneXpert MTB/RIF combined with gene chip technology for the smear-negative pulmonary tuberculosis.ROC analysis was used to evaluate the diagnostic value of serum sTREM-1 and PCT in smear-negative pulmonary tuberculosis.ResultsA total of 58 patients with non-smear-negative pulmonary tuberculosis and 72 patients with smear-negative pulmonary tuberculosis were diagnosed by using the alveolar lavage fluid tuberculosis culture method.The sensitivity of GeneXpert MTB/RIF combined with gene chip technology for the diagnosis of pulmonary tuberculosis was 68.06%,which was higher than that of gene chip method alone(P<0.05).The specificity,accuracy,positive predictive value and negative predictive value of GeneXpert MTB/RIF combined with gene chip method for the diagnosis of pulmonary tuberculosis were 91.38%,78.46%,90.74%and 69.74%,respectively,despite that the differences were not statistically significant when compared with the GeneXpert MTB/RIF or gene chip method alone(P>0.05).The sensitivity,specificity,accuracy,positive predictive value and negative predictive value of GeneXpert MTB/RIF combined with gene chip method for the diagnosis of MDR-TB were 94.12%,85.45%,87.50%,66.6
作者
苗雨
段月庭
MIAO Yu;DUAN Yueting(Department of Clinical Laboratory,Liaocheng People's Hospital,Liaocheng,Shandong,252000,China;Department of Tuberculosis,Liaocheng Institule of Cancer Prevention and Treatment,Liaocheng,Shandong,252000,China)
出处
《医学分子生物学杂志》
CAS
2022年第5期409-414,共6页
Journal of Medical Molecular Biology
基金
山东省卫健委医药卫生科技发展计划项目(No.2018WS411)。
关键词
利福平耐药实时荧光定量核酸扩增技术
基因芯片
涂阴结核分支杆菌
诊断价值
可溶性髓系细胞触发受体-1
降钙素原
rifampicin resistant real-time fluorescent quantitative nucleic acid amplification technology
gene chip method
smear-negative Mycobacterium tuberculosis
diagnostic value
soluble triggering receptor-1 of myeloid cells
procalcitonin
