摘要
目的探讨利福平耐药实时荧光定量核酸扩增检测技术(GeneXpert MTB/RIF)联合结核感染T细胞斑点试验(T⁃SPOT)对泌尿系结核(urinary tuberculosis,UTB)的诊断效能。方法选择2017年1月至2018年12月河南省胸科医院就诊临床疑似UTB的病人。分别采集样本进行抗酸涂片、液体培养、GeneXpert MTB/RIF和T⁃SPOT检测。使用χ2检验对不同检测方法的灵敏度进行比较。结果其中42例(47.1%)病人临床确诊为泌尿系结核。在泌尿系结核病例中,单项检测的阳性率最高的为T⁃SPOT,达到85.7%(36/42),但其在非泌尿系结核病例中的阳性率也最高,达到25.5%(12/47)。GeneXpert MTB/RIF和T⁃SPOT联合检测的特异度为100%;其联合检测灵敏度为89.4%,显著高于其他四项单独检测,分别为:抗酸涂片11.8%(χ2=57.225,P<0.001)、液体培养法42.8%(χ2=19.112,P<0.001)、GeneXpert MTB/RIF检测64.2%(χ2=7.823,P<0.01)和T⁃SPOT检测85.7%(χ2=2.573,P<0.05)。结论GeneXpert MTB/RIF和T⁃SPOT联合检测对于泌尿系结核的临床诊断有很好的临床应用价值,值得广泛推广应用。
Objective To investigate the diagnostic efficacy of GeneXpert MTB/RIF combined with T⁃SPOT for urinary tuberculosis.Methods Patients with clinically suspected urinary tuberculosis from January 2017 to December 2018 in Henan Provincial Chest Hospital were selected.Samples were collected for acid⁃fast smear,liquid culture,GeneXpert MTB/RIF and T⁃SPOT tests.The chi⁃square test was used to compare the sensitivity of different detection methods.Results A total of 89 cases met the inclusion crite⁃ria.Among them,42 cases(47.1%)were diagnosed clinically as urinary tuberculosis.Among these cases,the highest positive rate was T⁃SPOT,which reached 85.7%(36/42),but its positive rate in non⁃urinary TB cases was also the highest 25.5%(12/47).The specificity of GeneXpert MTB/RIF and T⁃SPOT combined detection was 100%.The sensitivity was 89.4%,which was significantly higher than that of the other four separate tests:11.8%for acid⁃fast smear(χ=57.225,P<0.001),42.8%for liquid culture method(χ=19.112,P<0.001),64.2%for GeneXpert MTB/RIF test(χ=7.823,P<0.01)and 85.7%for the T⁃SPOT test(χ=2.573,P<0.05).Conclusion The combination of GeneXpert MTB/RIF and T⁃SPOT detection has a good value for the clinical diagnosis of urinary tuberculosis,which is worthy of widespread application.
作者
吴素方
梁丽丽
郑淑兰
刘新
WU Sufang;LIANG Lili;ZHENG Shulan;LIU Xin(Department of Tuberculosis Infection,Henan Provincial Chest Hospital,Zhengzhou,Henan 450003,China)
出处
《安徽医药》
CAS
2020年第1期87-90,共4页
Anhui Medical and Pharmaceutical Journal
基金
河南省科技攻关项目（152102310152)
关键词
结核
泌尿生殖系统
结核菌素试验
核酸扩增技术
聚合酶链反应
利福平
Tuberculosis
urogenital
Tuberculin test
Nucleic acid amplification techniques
Polymerase chain reaction
Rifampin
