摘要
目的 评价分子生物学检测技术GeneXpert MTB/RIF(以下简称GeneXpert)在北京市石景山区的应用效果。方法 回顾性分析2019-2021年石景山区结核病防治所接诊的疑似肺结核病例资料,共计277例。其中117例临床最终诊断为活动性肺结核,病原学阳性病例69例。以临床最终诊断为标准,对痰样本的痰涂片、罗氏固体培养法(以下简称培养法)、GeneXpert检测结果进行比较分析,评价3种检测方法的效能。结果 痰涂片、培养法、GeneXpert阳性检出率分别为20.51%(24/117)、34.19%(40/117)和57.26%(67/117),差异有统计学意义(χ^(2)=35.026,P<0.001)。以临床最终诊断为标准,GeneXpert检测方法灵敏度、符合率和阴性预测值分别为57.26%(67/117)、81.59%(226/277)和76.08%(159/209),优于痰涂片、培养法。痰涂片、培养法、GeneXpert与临床最终诊断的Kappa值分别为0.230、0.375和0.600,痰涂片、培养法与临床诊断最终结果一致性较差,GeneXpert与临床最终诊断结果呈中度一致。2019-2021年,利福平耐药检出率分别为6.00%、8.33%和6.45%。结论 GeneXpert的应用显著提高了石景山区结核分枝杆菌检出率。
Objective To evaluate the application effect of GeneXpert MTB/RIF(GeneXpert) in Shijingshan district.Methods A total of 277 cases of suspected pulmonary tuberculosis(PTB) received by Shijingshan district tuberculosis control center from 2019 to 2021 were retrospectively analyzed. Among them, 117 cases were clinically diagnosed as active PTB, and 69 cases were pathologically positive. Taking the final clinical diagnosis as the standard, the test result of sputum smear, Roche solid culture method(culture method) and GeneXpert of sputum samples were compared and analyzed to evaluate the detection rate of the three detection method.Results The detection rates of sputum smear, culture method and GeneXpert were 20.51%(24/117), 34.19%(40/117) and 57.26%(67/117), respectively, with statistically significant differences(χ^(2)=35.026,P<0.001). Based on the final clinical diagnosis, the sensitivity, coincidence rate and negative predictive value of GeneXpert were 57.26%(67/117), 81.59%(226/277) and 76.08%(159/209), respectively, which were superior than sputum smear and culture method. The Kappa values for sputum smear, culture method and GeneXpert with the final clinical diagnosis were 0.230, 0.375 and 0.600 respectively. Sputum smear and culture method showed poor consistent with the final clinical diagnosis, and GeneXpert showed moderately consistent with the final clinical diagnosis. From 2019 to 2021, the detection rates of rifampicin-resistant tuberculosis were 6.00%, 8.33% and 6.45% respectively. Conclusions By applying GeneXpert, the detection rate of Mycobacterium tuberculosis in Shijingshan district has been significantly improved.
作者
邰剑敏
张绚
李传友
刘聪伟
邢玉鹏
常志帅
TAI Jian-min;ZHANG Xuan;LI Chuan-you;LIU Cong-wei;XING Yu-peng;CHANG Zhi-shuai(Shijingshan District Center for Disease Prevention and Control,Beijing 100043,China)
出处
《首都公共卫生》
2022年第5期257-260,共4页
Capital Journal of Public Health
基金
首都卫生发展科研专项-重点攻关(编号:2022-1G-3012)。
