迪澳结核分枝杆菌恒温核酸检测法、Xpert MTB/RIF检测法与传统固体罗氏培养法的比较

Comparative analysis of constant temperature nucleic acid detection method of X-ray tuberculosis, Xpert MTB/RIF detection method and traditional solid Roche culture method

目的比较不同检测方法在结核分枝杆菌检测中的应用及价值。方法选取2018年6月至2019年5月间在惠州市结核病防治研究所结核科就诊的400份结核病患者的标本进行研究,分别采用迪澳恒温核酸检测、Xpert检测、固体培养以及痰涂片四种方法进行检测,并分析四种检测方法的阳性率。结果迪澳恒温核酸检测法、Xpert检测法、固体培养检测法、痰涂片检测法的阳性率分为78.00%(312/400)、76.25%(305/400)、63.50%(254/400)和62.00%(248/400)。迪澳恒温核酸检测法和Xpert检测法均高于固体培养和痰涂片检测法,差异有统计学意义(P<0.05)。迪澳恒温核酸和Xpert检测法均敏感度和特异度高于固体培养和痰涂片检测法,但差异无统计学意义(P>0.05)。对四种方法进行Kappa检验,检测结果一致性均比较高,K值分别为0.523,0.769,0.627和0.546。结论结核分枝杆菌常见的检测方法中,迪澳恒温核酸和Xpert检测的阳性率、敏感度和特异度要高于固体培养和及痰涂片检测,但四种检测方法的检测结果一致性和约登指数均比较高,若联合使用效果可能更佳。

Objective To compare the application and value of different detection methods in the detection of Mycobacterium tuberculosis. Methods A total of 400 specimens of tuberculosis patients admitted to the Tuberculosis Department of Huizhou City Tuberculosis Prevention and Control Research Institute from June 2018 to May 2019 were selected.They were treated with Diol constant nucleic acid test,Xpert test,solid culture and sputum smear.Methods were tested and the positive rates of the four assays were analyzed. Results The positive rates of Dio's constant temperature nucleic acid assay,Xpert assay,solid culture assay,and sputum smear assay were 78.00%(312/400),76.25%(305/400),63.50%(254/400) and 62.00%(248/400),respectively.Diol constant nucleic acid detection method and Xpert detection method were higher than solid culture and sputum smear detection method,the difference was statistically significant ( P <0.05).The sensitivity and specificity of Dio's constant temperature nucleic acid and Xpert assay were higher than those of solid culture and sputum smear test,but the difference was not statistically significant ( P >0.05).Kappa test was performed on the four methods,and the consistency of the test results was relatively high.The K values were 0.523,0.769,0.627 and 0.546,respectively. Conclusion In the common detection methods of Mycobacterium tuberculosis,the positive rate,sensitivity and specificity of Diol constant nucleic acid and Xpert detection are higher than those of solid culture and sputum smear test,but the test results of the four test methods are consistent and approximate.The index is relatively high,and the combined effect may be better.