Gene X-pert MTB/RIF检测在尘肺病人中的应用

Application of Gene X-Pert MTB/RIF detection in patients with pneumoconiosis

目的:探讨Gene X-pert MTB/RIF技术在尘肺病人中的应用价值。方法:对湖南省职业病防治院2020年4月1日~2022年6月30日疑似结核感染的尘肺住院患者的痰或肺泡灌洗液标本进行抗酸染色,运用Gene X-pert MTB/RIF技术检测结核分枝杆菌(Mycobacterium tuberculosis,MTB)及利福平耐药基因,使用卡方检验统计分析尘肺病人不同分期MTB阳性率的差异;利用全自动生化仪检测血清蛋白质含量,用t检验统计分析尘肺合并结核与尘肺未合并结核感染患者血清蛋白含量的差异。结果:尘肺患者中痰或肺泡灌洗液涂片抗酸染色阳性率为2.1%,Gene X-pert MTB/RIF检测MTB阳性率为5.1%,其中利福平耐药的病人占14.6%。尘肺患者不同分期三组间Gene X-pert MTB/RIF检测阳性率差异有统计学意义;尘肺合并结核感染患者白蛋白含量明显低于未合并结核感染患者,而血清总蛋白含量无明显差异。结论:Gene X-pert MTB/RIF技术可提高尘肺患者并发肺结核和利福平耐药的检出率;随着患者尘肺等级的增高,其Gene X-pert MTB /RIF 检测阳性率升高,且尘肺合并结核比未合并结核感染患者白蛋白水平降低。

Objective To explore the application value of Gene X-Pert MTB / RIF technique in patients with pneumoconiosis.Methods The sputum or alveolar lavage fluid samples of pneumoconiosis inpatients suspected of tuberculosis infection in Hunan Provincial Hospital of Occupational Disease Prevention from April 1,2020 to June 30,2022 were stained with acid-fast staining,and the genes of Mycobacterium tuberculosis (MTB) and the gene resistant to rifampicin was detected by Gene X-Pert MTB/RIF technique.Chi-square test was used to analyze the positive rate of MTB in pneumoconiosis patients with different stages;Serum protein content was detected by automatic biochemical analyzer.T test was used to analyze the difference of serum protein content between pneumoconiosis patients with tuberculosis and pneumoconiosis patients without tuberculosis infection.Results In pneumoconiosis patients,the positive rate of acid-fast staining of sputum or alveolar lavage fluid smear was 2.1%,the positive rate of MTB detected by Gene X-PERT MTB/RIF technique was 5.1%,and the positive rate of the gene resistant to rifampicin was accounted for 14.6%.There were significant differences in the Gene X-PERT MTB/RIF positive rates among the three groups of pneumoconiosis patients with different stages.The albumin content of pneumoconiosis patients with tuberculosis infection was significantly lower than that of patients without tuberculosis infection,but there was no significant difference in serum total protein content.Conclusion Gene X-Pert MTB/RIF improves the detection rate of pulmonary tuberculosis and rifampicin resistance in patients with pneumoconiosis.The positive rate of Gene X-Pert MTB /RIF increased with the increase of pneumoconiosis grade.The albumin level of pneumoconiosis patients with tuberculosis was lower than that of patients without tuberculosis infection.