GeneXpertMTB/RIF实时荧光定量PCR系统在肺结核诊断及利福平耐药检测中的应用

Application of GeneXpertMTB/RIF-real time fluorescent quantitative PCR system in the diagnosis of pulmonary tuberculosis and rifampin resistance test

目的探讨GeneXpertMTB/RIF系统在肺结核的诊断及利福平耐药检测中的价值。方法选取246例肺结核患者痰标本,分别进行GeneXpertMTB/RIF系统、BACTEC MGIT 320全自动分枝杆菌快速培养及药敏试验和涂片抗酸染色镜检,对比分析结果。结果 246例肺结核患者中,GeneXpertMTB/RIF系统、MGIT 320培养和涂片抗酸染色镜检的阳性率分别为49.6%、43.1%和28.5%;在106例肺结核确诊患者中,3者阳性率分别为100.0%、100.0%和66.0%;在140例肺结核临床诊断患者中,3者阳性率分别为11.4%、0.0%和0.0%。在106例GeneXpertMTB/RIF系统检测阳性且MGIT 320培养阳性并鉴定为MTB的菌株中,GeneXpertMTB/RIF系统检测利福平耐药27例,MGIT 320液体药敏检测利福平耐药28例。结论 GeneXpertMTB/RIF系统在结核病的早期诊断和治疗、疗效观察等方面具有重要价值。

Objective To investigate the value of GeneXpertMTB/RIF system in the diagnosis of pulmonary tuberculosis and detection of rifampin resistance. Methods Sputum samples were collected from 246 patients with pulmonary tuberculosis,and the samples were conducted for the determination by GeneXpertMTB/RIF system,Mycobacterium tuberculosis（ MTB） culture and acid fast staining test,and the results were analyzed and compared. Results In 246 tuberculosis cases,the positive rates of GeneXpertMTB/RIF system,MTB culture and acid fast staining test were 49. 6%,43. 1% and 28. 5%; in 106 confirmed cases,the positive rate of them were 100. 0%,100. 0% and 66. 0%. Meanwhile,in 140 clinical diagnosed tuberculosis cases,the positive rates were 11. 4%,0. 0% and 0. 0%. In 106 cases with GeneXpertMTB/RIF system and MGIT320 cultivate positive detection and identification for MTB strains,there are 27 cases of rifampin resistant tested by GeneXpertMTB/RIF system,28 cases of rifampin resistant tested by MGIT320 liquid sensitiveness test. Conclusion GeneXpertMTB/RIF system plays an important role in the early diagnosis and the treatment of tuberculosis and in the observation of curative effect.