利福平耐药实时荧光定量核酸扩增技术在肺结核临床路径中的应用效果分析

Application effect of Xpert MTB DNA and resistance to rifampicin in the clinical pathway of pulmonary tuberculosis

目的探析肺结核(PTB)临床路径中应用利福平耐药实时荧光定量核酸扩增技术(Xpert技术)的价值。方法649例疑似PTB患者,随机分为观察组(327例)及对照组(322例)。观察组应用Xpert技术检测,对照组应用BD960液体培养技术检测。对比两组的诊断效能(敏感度、特异度、阴性预测值及阳性预测值)、诊断时间及临床诊疗路径指标(住院天数、治疗周期、检测费用)。结果观察组的敏感度、特异度、阴性预测值及阳性预测值分别为98.39%、88.24%、75.00%、99.35%,均明显高于对照组的95.35%、47.62%、41.67%、96.31%,差异有统计学意义(P<0.05)。观察组的诊断时间为(2.13±0.26)h,明显短于对照组的(324.57±102.32)h,差异有统计学意义(P<0.05)。观察组的初治、复治、耐多药结核(MDR-TB)患者住院天数、治疗周期均短于对照组,检测费用均低于对照组,差异均有统计学意义(P<0.05)。结论Xpert技术应用于PTB临床路径中临床效果显著,具有较高敏感度、特异度,且可以缩短检测时间,降低检测费用,缩短住院及治疗周期,值得临床推广。

Objective To discuss the value of Xpert MTB DNA and resistance to rifampicin(Xpert technology)in the clinical pathway of pulmonary tuberculosis.Methods A total of 649 patients with suspected PTB were randomly divided into observation group(327 cases)and control group(322 cases).The observation group was detected by Xpert technology,and the control group was detected by BD960 liquid culture technology.The diagnostic efficacy(sensitivity,specificity,negative predictive value and positive predictive value),diagnostic time and clinical diagnosis and treatment path indicators(hospitalization time,treatment cycle,and testing costs)were compared between the two groups.Results The sensitivity,specificity,negative predictive value,and positive predictive value of the observation group were 98.39%,88.24%,75.00%,and 99.35%,respectively,which were significantly higher than 95.35%,47.62%,41.67%,and 96.31%of the control group,and the difference was statistically significant(P<0.05).The diagnosis time(2.13±0.26)h of the observation group was significantly shorter than(324.57±102.32)h of the control group,and the difference was statistically significant(P<0.05).The hospitalization time and treatment cycle of patients with initial treatment,retreatment,and multidrug-resistant tuberculosis(MDR-TB)in the observation group were shorter than those in the control group,and the testing costs were lower than those in the control group,and the difference was statistically significant(P<0.05).Conclusion The application of Xpert technology has significant clinical effects in the clinical pathway of PTB,with high sensitivity and specificity,and can shorten the testing time and,reduce testing cost,shorten the hospitalization time and treatment cycle,which is worthy of clinical promotion.