探针熔解曲线在耐药结核病快速筛查中的临床应用研究

Clinical Application of Probe Melting Curve in Rapid Screening of Drugresistant Tuberculosis

目的研究探针熔解曲线在耐药结核病快速筛查中的临床应用价值。方法选取2020年1月—2021年3月镇江市第三人民医院收治的378例肺结核患者为研究对象,依次完成传统罗氏固体药物敏感性检测(比例法)、探针熔解曲线技术检测常用的6种药物耐药结果,包含利福平、异烟肼、乙胺丁醇、链霉素、氧氟沙星、阿米卡星,和比例法进行对比,计算探针熔解曲线技术检测6种药物的敏感度、特异度、阳性预测值、阴性预测值、符合率与约登指数。结果与比例法作比较,熔解曲线技术检测利福平耐药性的敏感度、特异度、阳性预测值、阴性预测值、符合率、约登指数分别为91.70%、98.10%、61.10%、99.70%、97.90%、0.898;异烟肼是87.90%、94.20%、59.20%、98.80%、93.65%、0.821;乙胺丁醇是87.50%、97.03%、38.89%、99.72%、96.83%、0.845;链霉素是91.30%、98.19%、87.50%、98.79%、97.35%、0.895;氧氟沙星是94.74%、98.89%、81.82%、99.72%、98.68%、0.936;阿米卡星是80.00%、99.46%、66.67%、99.73%、99.21%、0.795。结论探针熔解曲线在耐药结核病快速筛查中应用,具有较高敏感度及特异度,有利于临床早期识别耐药现象。

Objective To study the clinical application value of probe melting curve in rapid screening of drugresistant tuberculosis.Methods 378 patients with pulmonary tuberculosis admitted to the Third People′s Hospital of Zhenjiang City from January 2020 to March 2021 were taken as the research object,and the traditional Roche solid drug sensitivity test(proportional method)and probe melting curve technique were completed in turn.Only six commonly used drugs were selected to analyze the drug resistance results,including rifampicin,isoniazid,ethambutol,streptomycin,ofloxacin and amikacin,and compared with the proportional method,and the probe melting curve technique was calculated.Results Compared with the proportional method,the sensitivity,specificity,positive predictive value,negative predictive value,coincidence rate and Jordan index of melting curve technique in detecting rifampicin resistance were 91.70%,98.10%,61.10%,99.70%,97.90%and 0.898,respectively;isoniazid were 87.90%,94.20%,59.20%,98.80%,93.65%,0.821;ethambutol were 87.50%,97.03%,38.89%,99.72%,96.83%and 0.845;streptomycin were 91.30%,98.19%,87.50%,98.79%,97.35%,0.895;ofloxacin was 94.74%,98.89%,81.82%,98.89%,98.68%,0.936;amikacin was 80.00%,99.46%,66.67%,99.73%,99.21%and 0.795.Conclusion The application of probe melting curve in rapid screening of drug-resistant tuberculosis has high sensitivity and specificity,which is beneficial to early clinical identification of drug resistance.