GeneXpert法检测痰液在肺结核诊断中的价值

The value of sputum detection by GeneXpert method in the diagnosis of pulmonary tuberculosis

目的:探讨Gene Xper t法检测痰液在肺结核诊断中的临床价值。方法:选取2020年12月—2021年3月在滨州市结核病防治院确诊的住院肺结核患者123例,123例患者各留取晨痰3~5 m L于无菌痰盒中,分别采用GeneXpert法、痰TB-DNA定性法、痰培养法、痰抗酸染色涂片法进行检测,对比不同组别中的诊断结果。结果:123例肺结核患者GeneXpert法阳性89例(72.36%),痰TB-DNA定性法阳性76例(61.79%),痰培养法阳性56例(45.53%),痰抗酸染色涂片法阳性49例(39.84%)。GeneXpert法和痰培养法结果比较,差异有统计学意义(χ^(2)=18.293,P<0.001);痰TB-DNA定性法和痰培养法结果比较,差异有统计学意义(χ^(2)=6.539,P=0.011);痰抗酸染色涂片法和痰培养法结果比较,差异无统计学意义(χ^(2)=0.814,P=0.367);GeneXpert法和痰TB-DNA定性法结果比较,差异无统计学意义(χ^(2)=3.11,P=0.078)。123例患者经痰液检测,菌阳组阳性检出率显著高于菌阴组,菌阳和菌阴组GeneXpert法检测结果比较,差异有统计学意义(χ^(2)=18.229,P<0.001)。结论:GeneXpert法检测患者痰液在肺结核诊断中有较高应用价值,且快速、简便,值得临床应用。

Objective To explore the clinical application value of sputum detection by GeneXpert in the diagnosis of pulmonary tuberculosis.Methods From December 2020 to March 2021,a total of 123 inpatients with confirmed tuberculosis in Binzhou Tuberculosis Hospital were enrolled,morning sputum 3 to 5 mL samples were collected from each patient and detected Mycobacterium tuberculosis by GeneXpert method,Sputum TB-DNA qualitative method,sputum culture and acid-fast staining smear,respectively,the diagnostic efficacy of different groups was compared.Results Among the samples from 123 patients,89(72.36%)were positive by GeneXpert method,76(61.79%)were positive by Sputum TB-DNA qualitative method,56(45.53%)were positive by sputum culture,and 49(39.84%)were positive by sputum acid-fast staining smear.There was significant difference between GeneXpert method and sputum culture results(χ^(2)=18.293,P<0.001);The results of Sputum TB-DNA qualitative method and sputum culture method were significantly different(χ^(2)=6.539,P=0.011);The results of acid-fast staining smear and sputum culture method were significantly no different(χ^(2)=0.814 P=0.367);There was no significant difference between the results of GeneXpert method and sputum TB-DNA qualitative method(χ^(2)=3.11,P=0.078).The 123 sputum samples were then divided into two groups,bacteria positive group and bacteria negative group.The positive rate of the bacteria positive group was significantly higher than bacteria negative group.The results of GeneXpert method were statistically significant(χ^(2)=18.229,P<0.001)between bacteria positive group and bacteria negative group.Conclusion GeneXpert method has great application value in the diagnosis of pulmonary tuberculosis,and it is rapid,simple and worthy of popularization and application.