摘要
目的探讨Gene Xpert MTB/RIF技术在结核分枝杆菌(MTB)快速检测中的应用价值。方法收集2020年1月至2022年10月在南昌市第九医院就诊的疑似结核病患者送检的314例痰样本,分别采用Gene XpertMTB/RIF技术、抗酸染色法以及液体培养法进行检测,比较3种检测方法MTB阳性检出率,并以液体培养法检测结果为“金标准”,评估Gene Xpert MTB/RIF技术对MTB的检测效能。结果314例样本经GeneXpertMTB/RIF技术、抗酸染色法和结核分枝杆菌液体培养法检测,其阳性率分别为36.94%、12.10%和36.31%,Gene Xpert MTB/RIF技术和液体培养法MTB的阳性检出率高于抗酸染色法,差异有统计学意义(P<0.05)。以液体培养法为“金标准”,GeneXpertMTB/RIF技术MTB的检测敏感度为95.61%,特异度为96.50%;抗酸染色法的检测敏感度为31.58%,特异度为99.00%;Gene Xpert MTB/RIF技术的敏感度高于抗酸染色法,差异有统计学意义(P<0.05)。经Kappa分析发现Gene Xpert MTB/RIF技术与液体培养法检测MTB的一致性好(Kappa=0.918),而抗酸染色法与液体培养法检测结果的一致性较差(Kappa=0.357)。相比抗酸染色法,Gene XpertMTB/RIF技术有更高的正确检出率,联合使用可有效降低MTB的漏检率。结论GeneXpertMTB/RIF技术在MTB检测中具有敏感度高、特异性好等特点,有较高的临床应用价值。
Objective To investigate the clinical value of Gene Xpert MTB/RIF assay in the rapid detection of mycobacterium tuberculosis(MTB).Methods A total of 314 sputum samples from patients with suspected tuberculosis were collected in the Ninth Hospital of Nanchang City from January 2020 to October 2022.All the samples were tested using Gene Xpert MTB/RIF assay,acid-fast staining method and liquid culture method,respectively.The positive detection rates of the 3 detection methods were compared and the results of liquid culture method were set as the“gold standard”to evaluate the efficiency of Gene Xpert MTB/RIF assay in the detection of MTB.Results The positive detection rates of 314 samples in Gene Xpert MTB/RIF assay,acid-fast staining method and liquid culture method were 36.94%,12.10%and 36.31%,respectively;the positive detection rates of MTB in Gene Xpert MTB/RIF assay and liquid culture method were higher than that in acid-fast staining method,and the difference was statistically significant(P<0.05).With the results of liquid culture method as the“gold standard”,the sensitivity and specificity of Gene Xpert MTB/RIF assay were 95.61%and 96.50%,respectively;the sensitivity and specificity of acid-fast staining method were 31.58%and 99.00%,respectively;the sensitivity of Gene Xpert MTB/RIF assay was higher than that of acid-fast staining,and the difference was statistically significant(P<0.05).Kappa analysis revealed that there was good agreement between Gene Xpert MTB/RIF assay and liquid culture method in the detection of MTB(Kappa=0.918),whereas poor agreement was found between acid-fast staining and liquid culture(Kappa=0.357).Compared with acid-fast staining,Gene Xpert MTB/RIF assay had a higher rate of correct detection,and the combination of them could effectively reduce the missed detection rate of MTB.Conclusions Gene Xpert MTB/RIF assay is characterized by high sensitivity and good specificity in the detection of MTB,which suggests that it has potential value in clinical practice.
作者
赖启南
李雯
LAI Qi-nan;LI Wen(Department of Clinical Laboratory,the Ninth Hospital of Nanchang City,Nanchang 330002,China;Department of Science and Education,the Ninth Hospital of Nanchang City,Nanchang 330002,China)
出处
《实用临床医学（江西）》
CAS
2024年第4期11-13,18,共4页
Practical Clinical Medicine
基金
江西省卫健委科技计划(202140126)。
