Xpert MTB/RIF技术检测对痰标本中结核分枝杆菌的准确度及其对利福平药敏结果的影响

Influence on Xpert MTB/RIF Technique in Accuracy of Mycobacterium TB in Sputum Specimens and Results of Rifampicin Susceptibility

目的:探究Xpert结核分枝杆菌/利福平(Xpert MTB/RIF)技术检测痰液中结核分枝杆菌准确度及其对利福平药敏结果的影响。方法:选取医院2018年11月—2019年10月期间收治的疑似肺结核患者70例资料,统计其Xpert MTB/RIF技术检测痰液中结核分枝杆菌的结果;并以结核分枝杆菌培养及比例法药敏试验结果为金标准,比较和分析Xpert MTB/RIF技术检测对结核分枝杆菌的敏感度、特异度及准确度,以及Xpert MTB/RIF与比例法检测药敏试验结果的一致性。结果:经结核分枝杆菌培养结果发现,70例疑似肺结核患者中59例被确诊为肺结核,采用Xpert MTB/RIF检测及痰涂片诊断的特异度分别为100.00%、90.91%;采用Xpert MTB/RIF检测结核分枝杆菌的敏感度、准确度分别为38.98%、48.57%;而痰涂片法检测结核分枝杆菌的敏感度、准确度分别为16.95%、28.57%;经Kappa分析发现Xpert MTB/RIF检测法药敏试验利福平耐药性的一致性优于比例法(Kappa=0.782,P<0.05)。结论:Xpert MTB/RIF技术检测具有快速、便于操作的特点,在对结核分枝杆菌诊断的同时可以检测其对利福平耐药性,诊断结果具有客观性。

Objective:To explorate the influence on Xpert MTB/RIF technique in accuracy of Mycobacterium tuberculosis(MTB)in sputum specimens and results of rifampicin susceptibility.Methods:Data of 70 cases of suspected pulmonary tuberculosis patients admitted to the hospital from November 2018 to October 2019 were selected,and the results of Xpert MTB/RIF technique in the detection of MTB in sputum were analyzed.The sensitivity,specificity and accuracy of Xpert MTB/RIF test to MTB and the consistency of Xpert MTB/RIF test results with that of the proportional test were compared and analyzed.Results:According to the results of MTB culture,59 of the 70 suspected tuberculosis patients were diagnosed with tuberculosis.The specificity of Xpert MTB/RIF test and sputum smear were 100.00%and90.91%,respectively.The sensitivity and accuracy of Xpert MTB/RIF were 38.98%and 48.57%,respectively.The sensitivity and accuracy of MTB were 16.95%and 28.57%.Through Kappa analysis,it was found that the consistency of rifampicin resistance in Xpert MTB/RIF detection method was better than that of proportional method(K=0.782,P<0.05).Conclusion:Xpert MTB/RIF technique has the advantage of fast and easy operation,and the drug resistance to rifampicin can be detected at the same time as the diagnosis of MTB,so the diagnosis results are objective.