GeneXpert Mtb/RIF检测技术在利福平耐药结核病诊断中的应用价值

The Application Value of GeneXpert Mtb/RIF Detection Technology in the Diagnosis of Rifampicin-resistant Tuberculosis

目的探究GeneXpert Mtb/RIF检测技术对利福平耐药结核病的诊断效果。方法便利择取2017年1月—2019年1月期间该院收治的42例耐药结核病患者为研究对象,开展利福平药敏实验,比较GeneXpert Mtb/RIF检测与传统药敏实验检测结果。结果GeneXpert Mtb/RIF检测对耐药结核病诊断阳性率95.24%,涂片镜检的诊断阳性率78.57%,差异有统计学意义(χ2=5.126,P<0.05);GeneXpert Mtb/RIF检测与金标准检查结果差异无统计学意义(χ2=2.048,P>0.05)。GeneXpert Mtb/RIF诊断敏感度95.24%,特异度93.46%,涂片镜检诊断敏感度78.57%,特异度75.21%,差异有统计学意义(χ2=5.126、6.324,P<0.05)。GeneXpert Mtb/RIF检测利福平耐药敏感度为92.86%,特异度89.29%,与传统药敏实验相比差异无统计学意义(χ2=0.055、0.460,P>0.05)。结论GeneXpert Mtb/RIF检测对耐药结核病诊断效果与金标准具有良好一致性,其检测敏感度和特异度较高,对利福平耐药结核病具有良好的诊断效果,因此其可用于临床推广。

Objective To investigate the diagnostic effect of GeneXpert Mtb/RIF detection technology on rifampicin-resistant tuberculosis.Methods 42 patients with drug-resistant TB who were admitted to the hospital from January 2017 to January 2019 were convenienty selected into the study.The rifampicin susceptibility test was performed to compare the results of GeneXpert Mtb/RIF test with traditional susceptibility test.Results The positive rate of GeneXpert Mtb/RIF detection for drug-resistant tuberculosis was 95.24%,and the positive rate of smear microscopy was 78.57%.The difference was statistically significant(χ2=5.126,P<0.05).There was no significant difference in the results of GeneXpert Mtb/RIF test and gold standard examination(χ2=2.048,P>0.05).The diagnostic sensitivity of GeneXpert Mtb/RIF was 95.24%,the specificity was 93.46%,the sensitivity of smear microscopy was 78.57%,and the specificity was 75.21%.The difference was statistically significant(χ2=5.126,6.324,P<0.05).GeneXpert Mtb/RIF showed rifampicin resistance sensitivity of 92.86%and specificity of 89.29%.There was no significant difference compared with traditional susceptibility test(χ2=0.055,0.460,P>0.05).Conclusion The GeneXpert Mtb/RIF test has a good consistency with the gold standard for the diagnosis of drug-resistant tuberculosis.Its detection sensitivity and specificity are high.It has a good diagnostic effect on rifampicin-resistant tuberculosis,so it can be used for clinical promotion.