基因芯片技术联合T细胞斑点试验诊断肺结核及基因芯片技术检测耐药基因的应用研究

Application of gene chip technology combined with T-cell spot detection in diagnosis of pulmonary tuberculosis and drug resistance gene detection by gene chip technology

目的探讨基因芯片技术联合T细胞斑点试验(T-SPOT)对肺结核的诊断效能和基因芯片对结核分枝杆菌(MTB)耐药基因的检测效能。方法选取感染科收治的108例高度疑似肺结核患者作为研究对象,所有患者入院均接受基因芯片技术联合T-SPOT诊断。以痰MTB培养实验结果为“金标准”,评估基因芯片技术联合T-SPOT对肺结核的诊断效能。对所有确诊肺结核患者实施抗结核方案治疗,以DNA测序检测结果为“金标准”,评估基因芯片对MTB耐药基因的检测效能。结果108例高度疑似肺结核患者,经痰培养确诊肺结核100例,占92.59%;以痰MTB培养检测结果为“金标准”,基因芯片技术联合T-SPOT诊断肺结核的灵敏度、准确度均高于T-SPOT、基因芯片技术单一诊断,差异有统计学意义(P<0.05)。以DNA测序检测结果为“金标准”,基因芯片技术检测MTB耐药基因的灵敏度为92.31%,特异度为97.37%,准确度为96.08%。结论基因芯片技术联合T-SPOT诊断肺结核的灵敏度、准确度较高,且基因芯片技术对MTB耐药基因具有较高的检测效能。

Objective To explore the application value of gene chip combined with T cell spot detection(T-SPOT)in diagnosis of pulmonary tuberculosis,and to analyze the detection efficiency of gene chip for drug resistance genes of Mycobacterium tuberculosis(MTB).Methods A total of 108 patients with highly suspected pulmonary tuberculosis treated in the Department of Infection were selected as research subjects,all patients were diagnosed by genechip combined with T-SPOT at admission.Sputum tuberculosis culture experiment was used as the“gold standard”to evaluate the diagnostic efficacy of gene chip combined with T-SPOT technology in pulmonary tuberculosis.All confirmed patients were treated with anti-tuberculosis regimen,DNA sequencing was used as the“gold standard”to evaluate the detection efficiency of gene chip for MTB resistance genes.Results Of 108 patients with highly suspected pulmonary tuberculosis,100 cases were confirmed as pulmonary tuberculosis by sputum culture,accounting for 92.59%;the results of sputum tuberculosis culture were taken as the“gold standard”,the sensitivity and accuracy of T-SPOT combined with gene chip in the diagnosis of pulmonary tuberculosis were higher than that of single diagnosis,the difference was statistically significant(P<0.05).The results of DNA sequencing were taken as the“gold standard”,the sensitivity,specificity and accuracy of gene chip combined with T-SPOT for detecting MTB resistance genes were 92.31%,97.37%and 96.08%.Conclusion The sensitivity and accuracy of gene chip combined with T-SPOT in the diagnosis of pulmonary tuberculosis are high,gene chip has high detection efficiency in detecting MTB resistance genes.