基因芯片快速检测分枝杆菌技术辅助诊断小儿结核病的临床研究

Rapid Detection of Mycobacterium Tuberculosis by Gene Chip in the Diagnosis of Tuberculosis in Children

目的 探讨基因芯片快速检测分枝杆菌技术在辅助诊断小儿结核病方面的临床研究。方法 方便选取2014年7月—2015年7月住于该院的经临床、放射线疑诊0~14岁肺结核77例为观察对象,采用晶芯@结核病分子诊断系统对观察对象痰标本进行检测,将检测结果与最终诊断相比较,并与罗氏痰培养结核菌法、痰涂片找结核菌、DNA检测、PPD试验、结核抗体、对INH／RFP耐药性及对非结核分枝杆菌菌种鉴定结果进行对比,分别计算各检测方法的灵敏度和特异度,从而判断基因芯片技术在诊断儿童结核病可行性、敏感、快速。结果 重症结核感染17例,其中有9例（11.69%）为血行播散型肺结核,7例（9.09%）合并有结核性脑膜炎,1例（1.3%）合并骨结核。检测异烟肼耐药相关基因,基因芯片法和罗氏培养法比较χ^2=2.286,P=0.515,Kappa=0.604,检测利福平耐药相关基因,基因芯片法和罗氏培养法比较χ^2=58.77,P〈0.05,Kappa=0.587。基因芯片法与罗氏培养法、PPD试验、结核DNA、结核抗体、痰涂片多重比较,χ^2=64.91,P〈0.05。结果 基因芯片法可以快速检测结核分枝杆菌,与罗氏培养法检测结核分枝杆菌拥有中等一致性,其快速、无创,可以用于辅助诊断小儿结核病。

Objective To investigate the clinical study of rapid detection of Mycobacterium tuberculosis by gene chip in the diagnosis of pediatric tuberculosis. Methods Convenient selection clinical, X-ray suspected 0-14 years old pulmonary tuberculosis 70 cases in July 2014 to July 2015 live in our hospital as the observation object by Jingxin @ TB molecular diagnostic system of the observed object sputum specimens were detected, test results and final diagnosis was compared, in parallel with Roche sputum Mycobacterium tuberculosis, sputum smear, culture on the find tuberculosis bacteria, DNA testing,the PPD test, tuberculosis antibody, on drug resistance of INH\RFP and of non tuberculosis mycobacterium species identification results were compared were calculated sensitivity and specificity of the detection method, in order to determine the gene chip technique in the diagnosis of childhood tuberculosis feasibility, sensitive, rapid. Results 17 cases of severe tuberculosis infection, including 9 cases(11.69%) were blood disseminated pulmonary tuberculosis, 7 cases(9.09%) with tuberculous meningitis, 1 cases(1.3%) with bone tuberculosis. Detection of isoniazid resistant related genes and gene chip method and Roche culture method χ2=2.286, P = 0.515, Kappa = 0.604, detection of rifampin resistance related gene, gene chip method and Roche culture method χ2=58.77, P < 0.05, Kappa =0.587. Gene chip and Roche culture method, PPD test,tuberculosis DNA, tuberculosis antibody, sputum smear multiple comparison. χ2=64.91, P < 0.05. Conclusion The gene chip method can quickly detect Mycobacterium tuberculosis, and the Roche culture method for detection of Mycobacterium tuberculosis with moderate consistency, its rapid, noninvasive, can be used for the diagnosis of tuberculosis in children.