GeneXpert系统在肺结核中的诊断价值

目的评价GeneXpertMTB／RIF系统在肺结核中的诊断价值。方法对408例疑诊肺结核的患者痰样本分别进行痰抗酸镜检（AFB）、结核分枝杆菌培养（MTB）和GeneXpertMTB／RIF检测，并进行比较。结果以临床确诊为金标准，抗酸涂片镜检、TB培养和GeneXpertMTB／RIF检测的敏感性分别为85．7％、99．0％、100％；以临床确诊＋临床诊断为金标准，抗酸涂片镜检、TB培养和GeneXpertMTB／RIF检测的敏感性分别为38．O％％、43．9％、45．1％；GeneXpert敏感性高于抗酸涂片镜检（P〈0．05），等同于结核培养；GeneXpert菌量梯度与抗酸涂片镜检等级呈一定正相关（r=0．672）；GeneXpert利福平耐药测定与传统比例法药敏测定具有明显相关性（kappa=0．951）。结论GeneXpertMTB／RIF系统在肺结核诊断、疗效观察及预后评估具有重要价值。

Objective To evaluate the diagnostic value of GeneXpert MTB/RIF system in patients with pulmonary tuberculosis. Methods Total of 408 cases of sputum samples from the pulmonary tuberculosis and suspected pulmonary tuberculosis patients were collected, and tested by acid fast staining （ AFB ） , Mycobacterium tuberculosis （ MTB ） culture and GeneXpert MTB/RIF system, the Results were compared. Results Clinical confirmed diagnosis as gold standard, the susceptibility of acid fast staining, TB culture and GeneXpert MTB/RIF was 85.7%%, 99.0%, 100% respectively; Clinical confirmed diagnosis＋Clinical diagnosis as gold standard, the sensitive was 38.0%. 43.9%. 45.1% respectively; the sensitivity of GeneXpert MTB/RIF was higher than acid fast staining （P〈0.05） , equivalent to tuberculosis culture; GeneXpert MTB/RIF bacterial content gradient was positively correlated with acid fast staining （ r=0.672 ） ; GeneXpert determination of rifampin resistance and the proportion of drug sensitivity with good correlation （ kappa=0.951 ） . Conclusion GeneXpertMTB/RIF system has important value in the diagnosis, assessment of curative effect and prognosis of pulmonary tuberculosis.