摘要
目的研究痰涂片、痰培养和GeneXpert MTB/RIF检测方法对肺结核的诊断价值.方法回顾性分析2020年9月-2023年9月,在北京市昌平区结核病防治所就诊的2607例疑似肺结核患者资料,所有患者均进行痰涂片、结核分枝杆菌罗氏固体培养和GeneXpert MTB/RIF三种方法检测.此文对三种检测方法确诊活动性肺结核患者的阳性检出率进行分析,同时对病原学阳性病例中痰涂片阳性组和痰涂片阴性组的罗氏培养和GeneXpert MTB/RIF的阳性检出率进行分析.结果591例活动性肺结核患者中,339例病原学阳性,252例病原学阴性,其中痰涂片阳性检出率为30.63%(181/591),罗氏培养阳性检出率为35.87%(212/591),GeneXpert MTB/RIF阳性检出率为41.96%(248/591).病原学阳性病例中痰涂片阴性组罗氏培养阳性检出率为65.07%(95/146),GeneXpert MTB/RIF阳性检出率为80.82%(118/146),痰涂片阳性组罗氏固体培养阳性检出率为56.99%(110/193),GeneXpert MTB/RIF阳性检出率为62.18%(120/193).罗氏培养和GeneXpert MTB/RIF阳性检出率高于痰涂片(P<0.05),痰涂片阴性组GeneXpert MTB/RIF阳性检出率高于罗氏固体培养(P<0.05).结论罗氏固体培养和GeneXpert MTB/RIF检测可以弥补痰涂片检测的不足,提高MTB阳性检出率,GeneXpert MTB/RIF检测方法在痰涂片阴性的肺结核诊断中具有更高的临床价值.
Objective To study the diagnostic value of sputum smear,sputum culture and GeneXpert MTB/RIF detection in pulmonary tuberculosis.Methods A retrospective analysis was performed on the data of 2607 suspected pulmonary tuberculosis patients who were treated in the Tuberculosis Prevention and Control Center of Changping District,Beijing from September 2020 to September 2023.All patients were tested by sputum smear,Mycobacterium tuberculosis solid culture and GeneXpert MTB/RIF.The positive detection rate of three tests in patients diagnosed with active tuberculosis is analyzed,and the positive detection rate of culture and GeneXpert MTB/RIF is analyzed in smear-positive and smear-negative groups of pathogenetically positive cases.Results The 591 patients with active pulmonary tuberculosis,339 pathogenetically are positive and 252 are pathogenetically negative.The sputum smear positive rate is 30.63%(181/591),and the Roche culture positive rate is 35.87%(212/591).The positive rate of GeneXpert MTB/RIF is 41.96%(248/591).The positive rate of Roche culture in the negative smear group is 65.07%(95/146),the positive rate of GeneXpert MTB/RIF is 80.82%(118/146),and the positive rate of Roche culture in the positive smear group is 56.99%(110/193),the positive rate of GeneXpert MTB/RIF is 62.18%(120/193).The positive detection rate of Roche culture and GeneXpert MTB/RIF is higher than that of sputum smear(P<0.05),the positive detection rate of GeneXpert MTB/RIF in smear negative group is higher than that of Roche solid culture(P<0.05).Conclusion The solid culture of Roche and GeneXpert MTB/RIF detection can make up for the shortcomings of smear detection,and improve the positive detection rate of MTB.GeneXpert MTB/RIF detection method has higher clinical value in the diagnosis of pulmonary tuberculosis with negative sputum smear.
作者
吴进凤
Wu Jinfeng(Beijing Changping Institute for Tuberculosis Prevention and Treatment,Beijing 102200,China)
出处
《首都食品与医药》
2024年第15期90-92,共3页
Capital Food Medicine
