摘要
目的 分析微孔板法、实时荧光聚合酶链反应(PCR)熔解曲线法及结核分枝杆菌/利福平耐药实时荧光定量核酸扩增检测(GeneXpert MTB/RIF)用于快速筛查耐多药结核病(MDR-TB)的临床价值。方法 选取2020年1月—2023年12月于包头市第三医院就诊的肺结核患者126例,均行微孔板法、实时荧光PCR熔解曲线法及GeneXpert MTB/RIF检测,以罗氏药物敏感性试验(L-J药敏试验)结果作为金标准,比较上述三种方法检测耐多药结核病的灵敏度、特异度及准确度。结果 以L-J药敏试验作为金标准,微孔板法、实时荧光PCR熔解曲线法、GeneXpert MTB/RIF检测耐多药结核病的灵敏度分别为95.29%、92.94%、98.82%,特异度分别为87.80%、87.80%、90.24%,准确度分别为92.86%、91.27%、96.03%,且三种方法检测的灵敏度、特异度及准确度比较差异无统计学意义(P>0.05)。结论 微孔板法、实时荧光PCR熔解曲线法、GeneXpert MTB/RIF用于筛查MDR-TB均有较高的应用价值,临床可根据具体情况选择合适的检测方法。
Objective To analyze the clinical value of microtitre plate assay,real-time polymerase chain reaction(PCR)with melting curve analysis and GeneXpert Mycobacterium tuberculosis/rifampicin(MTB/RIF)assay in rapid screening of multidrug-resistant tuberculosis(MDR-TB).Methods A total of 126 patients with pulmonary tuberculosis who visited Third Hospital of Baotou from January 2020 to December 2023 were selected.All of them were tested by microtitre plate assay,real-time PCR with melting curve analysis and GeneXpert MTB/RIF.The Lowenstein-Jensen(L-J)culture test results were used as the gold standard to compare the sensitivity,specificity and accuracy among above three methods in detecting MDR-TB.Results With L-J test results as the gold standard,the sensitivity of microtitre plate assay,real-time PCR with melting curve analysis and GeneXpert MTB/RIF in detecting MDR-TB was 95.29%,92.94%and 98.82%.The specificity was 87.80%,87.80%and 90.24%.The accuracy rates were 92.86%,91.27%and 96.03%.There was no significant difference in sensitivity,specificity,or accuracy among the three methods(P>0.05).Conclusion Microtitre plate assay,real-time PCR with melting curve analysis and GeneXpert MTB/RIF all demonstrate relatively high application value in screening MDR-TB.The suitable detection method can be selected according to specific situation in clinical practice.
作者
董敖渤
张建强
段弘
范春霞
贾小青
DONG Aobo;ZHANG Jianqiang;DUAN Hong;FAN Chunxia;JIA Xiaoqing(Clinical Laboratory,Third Hospital of Baotou,Baotou,Neimenggu 014040;Department of Respiratory and Critical Care Medicine,Third Hospital of Baotou,Baotou,Neimenggu 014040)
出处
《智慧健康》
2025年第13期142-144,154,共4页
Smart Healthcare
基金
包头市卫生健康科技计划项目(2022年)《基于药物敏感试验分析2020-2023年耐药结核菌流行趋势及其影响因素的研究》(项目编号:wsjkkj2022106)。
作者简介
董敖渤(1989-),女,汉族,内蒙古赤峰人,研究生,主管检验师,研究方向:微生物耐药及流行病学分析。;通信作者:贾小青(1972-),女,汉族,内蒙古包头人,研究生,主任医师,研究方向:呼吸内科。
