XpertMTB/RIF在结核病诊断及利福平耐药中的应用

The application of XpertMTB/RIF in TB diagnosis and rifampicin resistance testing

目的评价XpertMTB/RIF技术在诊断结核病及利福平耐药中的临床应用价值。方法选取196例初诊患者痰标本,分别进行抗酸染色涂片镜检、罗氏固体培养、比例法药敏试验和XpertMTB/RIF检测,对XpertMTB/RIF检测痰标本中结核分枝杆菌(MTB)和利福平耐药性的敏感度和特异度,以及与金标准的一致性进行分析。结果以罗氏培养结果为金标准,XpertMTB/RIF方法检测MTB的敏感度为94.62%(123/130)、特异度为87.88%(58/66),kappa=0.828;以比例法药敏试验结果相比,XpertMTB/RIF方法检测利福平耐药的敏感度73.33%(11/15),特异度为96.30%(104/108),kappa=0.696。结论 XpertMTB/RIF在结核病诊断和利福平耐药检测中敏感度和特异度较高,与传统方法有很好的一致性,且更高效,快捷,安全,更符合成本-效益,值得推广。

Objective To evaluate the accuracy of XpertMTB/RIF assay in the diagnosis of tuberculosis and detection of rifampin resistance.Methods Atotal of 196 initial diagnosis patients were recruited,sputum samples of these patients were tected by smear,solid culture,traditional proportion method drug susceptibility test and XpertMTB/RIF test.The sensitivity and specificity of XpertMTB/RIF method in detecting mycobacterium tuberculosis（MTB）and refampin resistance,and the consistency of this method comparted with the gold standard were andyzed.Results According to the solid culture result,the sensivivity and specificity of XpertMTB/RIF test in detecting tuberculosis were 94.62%（123/130）and 87.88%（58/66）,kappa was 0.828;according to conventional drug susceptibility test result,the sensitivity and specificity in detecting rifampin resistance were 73.33%（11/15）and96.30%（104/108）respectively,kappawas 0.696.Conclusion The XpertMTB/RIF test has very high sensitivity and specificity,which also has a good consistency with the traditional method.It is a more efficient,rapid,safer and more cost-effective diagnosis tool for MTB and Rifampicin resistant.