[1]刘乃刚,高迎春.GeneXpertMTB/RIF对结核病的诊断价值及复治患者群体特征研究[J].医学信息,2023,36(06):134-138.[doi:10.3969/j.issn.1006-1959.2023.06.029]
　LIU Nai-gang,GAO Ying-chun.The Diagnostic Value of GeneXpertMTB/RIF in Tuberculosis and the Population Characteristics of Retreated Patients[J].Journal of Medical Information,2023,36(06):134-138.[doi:10.3969/j.issn.1006-1959.2023.06.029]
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GeneXpertMTB/RIF对结核病的诊断价值及复治患者群体特征研究()
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医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
36卷
期数:
2023年06期
页码:
134-138
栏目:
论著
出版日期:
2023-03-15

文章信息/Info

Title:
The Diagnostic Value of GeneXpertMTB/RIF in Tuberculosis and the Population Characteristics of Retreated Patients
文章编号:
1006-1959（2023）06-0134-05
作者:
刘乃刚; 高迎春
（1.宝应县人民医院检验科，江苏 宝应 225800；2.宝应县疾病预防控制中心检验科，江苏 宝应 225800）
Author(s):
LIU Nai-gang; GAO Ying-chun
(1.Department of Laboratory,Baoying County People’s Hospital,Baoying 225800,Jiangsu,China;2.Baoying County Center for Disease Control and Prevention,Baoying 225800,Jiangsu,China)
关键词:
GeneXpertMTB/RIF; 结核病; 诊断价值; 复治患者; 群体特征
Keywords:
GeneXpertMTB/RIF; Tuberculosis; Diagnostic value; Retreated patients; Population characteristics
分类号:
R52
DOI:
10.3969/j.issn.1006-1959.2023.06.029
文献标志码:
A
摘要:
目的 分析利福平耐药实时荧光定量核酸扩增检测技术（GeneXpertMTB/RIF）对结核病的诊断价值及复治患者群体特征研究。方法 选取2021年6月-2022年1月在宝应县人民医院诊治的126例疑似结核病患者，均进行痰涂片染色、改良罗氏培养法、GeneXpertMTB/RIF检测，观察不同检测方法对结核病诊断效能、分枝杆菌利福平药敏性以及复治患者群体特征。结果 GeneXpertMTB/RIF检测阳性率高于痰涂片染色、改良罗氏培养法检测阳性率（P＜0.05）；痰涂片染色+改良罗氏培养法+GeneXpertMTB/RIF联合检测敏感度均高于GeneXpertMTB/RIF、痰涂片染色、改良罗氏培养法单独检测，特异度小于改良罗氏培养法GeneXpertMTB/RIF、痰涂片染色，且GeneXpertMTB/RIF特异度小于改良罗氏培养法（P＜0.05）；GeneXpertMTB/RIF检测利福平结核分枝杆菌药敏结果与改良罗氏培养法结果一致性良好（Kappa=0.722，P＜0.05）；单因素分析显示，不同地区、职业、结核病接触史、治疗前症状和体征评分、既往治疗次数、既往用药种类、既往用药不良反应比较，差异有统计学意义（P＜0.05），而不同年龄、性别比较，差异无统计学意义（P＞0.05）；多因素Logistic回归分析，农村、农民、治疗前症状及体征评分≥6分、既往治疗＞2次是复治患者发生的独立危险因素（P＜0.05）。结论 GeneXpertMTB/RIF对结核病具有较高的诊断价值，且评估结核分枝杆菌的利福平敏感性一致性较好。结核病复治患者具有一定的群体特征，职业以农民为主，地域主要分布于农村，且服药不规律、既往治疗次数＞2次，临床可结合复治结核患者群特征，给予针对性防控，从而降低结核病复治发生率。
Abstract:
Objective To analyze the diagnostic value of rifampicin resistance real-time fluorescence quantitative nucleic acid amplification detection technology(GeneXpertMTB/RIF) for tuberculosis and the population characteristics of retreated patients.Methods From June 2021 to January 2022, 126 suspected tuberculosis patients diagnosed and treated in Baoying County People’s Hospital were selected for sputum smear staining, modified Roche culture method and GeneXpertMTB/RIF detection. The diagnostic efficacy of different detection methods for tuberculosis, drug sensitivity of mycobacterium rifampicin and group characteristics of retreated patients were observed.Results The positive rate of GeneXpertMTB/RIF was higher than that of sputum smear staining and modified Roche culture (P<0.05). The sensitivity of combined detection of sputum smear staining + modified Roche culture + GeneXpertMTB/RIF was higher than that of GeneXpertMTB/RIF, sputum smear staining and modified Roche culture alone, and the specificity was less than that of GeneXpertMTB/RIF and sputum smear staining of modified Roche culture, and the specificity of GeneXpertMTB/RIF was less than that of modified Roche culture (P<0.05). The results of GeneXpertMTB/RIF were consistent with those of modified Roche culture method (Kappa=0.722, P<0.05). Univariate analysis showed that there were statistically significant differences in different regions, occupations, history of tuberculosis exposure, scores of symptoms and signs before treatment, times of previous treatment, types of previous medication, and adverse drug reactions (P<0.05); there was no significant difference in age and gender (P>0.05). Multivariate logistic regression analysis showed that rural areas, farmers, pre-treatment symptoms and signs score ≥6 scores, and previous treatment >2 times were independent risk factors for retreated patients (P<0.05).Conclusion GeneXpertMTB/RIF has a high diagnostic value for tuberculosis, and the consistency of rifampicin sensitivity of Mycobacterium tuberculosis is good. The retreatment tuberculosis patients have certain group characteristics, the occupation is mainly farmers, the region mainly distributes in the countryside, and takes the medicine irregularly, the previous treatment time is more than 2 times. Clinically, targeted prevention and control can be given according to the characteristics of retreated tuberculosis patients, so as to reduce the incidence of retreatment of tuberculosis.

参考文献/References:

[1]陈子芳,孙本海,魏海冬,等.GeneXpertMTB/RIF技术对菌阴肺结核患者辅助诊断的价值[J].中国防痨杂志,2017,38(10):827-831.[2]高春景,朱述阳.支气管肺泡灌洗液行XpertMTB/RIF检测对涂阴肺结核的诊断价值[J].临床肺科杂志,2017,21(12):2192-2196.[3]韩丹,段慧楠,饶有益,等.纤维支气管镜灌液XpertMTB/RIF检测对肺结核诊断和利福平耐药菌株筛选的临床价值[J].医学综述,2016,22(16):3243-3246.[4]CanSarInoglu R,Sili U,Eryuksel E,et al.Tuberculosis and COVID-19:an overlapping situation during pandemic[J].J Infect Dev Ctries,2020,14(7):721-725.[5]唐亮,冯世庆,高瑞霄,等.利福平耐药实时荧光定量核酸扩增检测技术对脊柱结核不同类型标本检测的研究[J].中华实验外科杂志,2018,35(9):1764-1766.[6]王丹吉,刘巧,陆伟,等.基因芯片技术对耐多药结核病患者治疗的指导价值[J].南京医科大学学报(自然科学版),2018,38(7):983-987.[7]虞忻,宋华峰,冯彦军,等.Genexpert-MTB/RIF检测法在结核病诊断中的意义[J].实用医学杂志,2019,35(6):985-988.[8]熊宗年,张雪芹,陈艳.T-SPOT.TB和GeneXpertMTB/RIF检测在结核诊断中的应用[J]. 临床血液学杂志,2017,30(10):777-780. [9]陈子芳,周广信.GeneXpertMTB/RIF在结核病诊断及利福平耐药检测中的应用[J].国际流行病学传染病学杂志,2018(1):420-424.[10]刘洋.GeneXpertMTB/RIF技术在浅表淋巴结结核诊断中的应用价值研究[D].北京:北京市结核病胸部肿瘤研究所,2018.[11]肖东楼,王文杰,许绍发,等.中国结核病防治规划-痰涂片镜检标准化操作及质量保证手册[M].北京:人民卫生出版社,2018:9-15.[12]Ali M,Howady F,Munir W,et al.Drug-resistant tuberculosis: an experience from Qatar[J].Libyan J Med,2020,15(1):1744351.[13]周祎,张宁,刘晓荣,等.结核感染T淋巴细胞实验和Xpert MTB/RIF检测在糖尿病并发菌阴性肺结核患者诊断中的价值[J].陕西医学杂志,2019,48(7):885-889.[14]许圆圆,陈潇潇,陈喜凯,等.台州市2015-2017年涂阳肺结核病例耐药性分析[J].上海预防医学,2018,30(12):1012-1015.[15]周喜桃,张跃军,曾莉怡,等.Xpert MTB/RIF检测技术在结核病诊断中的价值[J].中国防痨杂志,2018,40(12):1335-1340.[16]陈新秀,郑成芳.结核感染T细胞试验对于肺结核诊断的意义研究[J].解放军预防医学杂志,2019,37(5):5-6.[17]Word Health Organization.Global tuberculosis report 2017[DB/OL].https://www.who.int/publications-detail-redirect/9789241565516,2017-01-01/2022-07-01.[18]李于于,曾令城,柳巍.2017-2018年西安市结核病耐药流行状况及相关因素分析[J].现代预防医学,2019,46(21):4001-4004.[19]张玉,侯双翼,周丽平,等.2007-2017年湖北省利福平耐药肺结核流行病学特征分析[J].疾病监测,2019,34(7):667-671.[20]马艳,杜建,高微微,等.377例复治肺结核患者耐药的危险因素研究[J].中国预防医学杂志,2018,19(9):641-643.

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更新日期/Last Update: 1900-01-01