3种常规结核分枝杆菌及耐药突变检测方法的对比研究
Journal of Hebei Medical University（2020）
Abstract
目的 评价3种实验室常规检测方法用于诊断肺结核患者结核分枝杆菌(Mycobacterium tuberculosis,MTB)及耐药突变情况的应用价值.方法 回顾性分析经临床确诊的肺结核患者246例,应用Gene Xpert MTB/RIF技术(Xpert法)、BD960液体快速培养法(BD960法)联合快速药物敏感试验(药敏试验)、MTB核酸检测联合MTB耐药基因(DNA芯片法)检测诊断MTB及耐药突变检出情况.结果 BD960法对MTB的阳性检出率低于MTB核酸检测和Xpert法,差异有统计学意义(P<0.05).药敏试验、MTB耐药基因检测和Xpert法利福平耐药检出率差异无统计学意义(P>0.05).与药敏试验利福平耐药结果相比,MTB耐药基因检测和Xpert法的敏感度、特异度、阳性预测值、阴性预测值、准确度和约登指数分别为91.30％、95.32％、84.00％、97.60％、94.47％、86.63％和95.65％、93.57％、80.00％、98.77％、94.01％、89.22％,X-pert法和MTB耐药基因检测利福平耐药结果高度一致(Kappa值=0.833,0.840).药物敏感试验和MTB耐药基因检测异烟肼耐药检出率差异无统计学意义(P>0.05).结论 BD960法、Xpert法和MTB核酸检测均能准确检测样本中的MTB,药敏试验、MTB耐药基因检测和Xpert法能分析MTB利福平(异烟肼)耐药情况,MTB耐药基因检测和Xpert法且具有较高的敏感度和特异度,可结合实际需求在耐多药结核病防治中应用.
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