| 周林.Xpert MTB/RIF在疑似淋巴结结核患者中诊断价值的研究[J].浙江中西医结合杂志,2019,29(5): |
| Xpert MTB/RIF在疑似淋巴结结核患者中诊断价值的研究 |
| Diagnostic value of Xpert MTB/RIF assay in patients with suspected tuberculous lymphadenitis |
| 投稿时间：2018-11-30 修订日期：2019-03-12 |
| DOI： |
| 中文关键词: Xpert MTB/RIF 结核性淋巴结炎 诊断 |
| 英文关键词:Xpert MTB/RIF Tuberculous lymphadenitis diagnosis |
| 基金项目:杭州市卫生科技计划 2016A33 |
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| 中文摘要: |
| 目的：探讨Xpert MTB/RIF技术在疑似淋巴结结核患者中的诊断价值。方法：连续收集2016.4-2018.4在我院就诊的100例初诊疑似淋巴结结核患者的淋巴结标本，分别应用Xpert MTB/RIF、病理检查及BACTEC MGIT 960液体快速培养对样本标本进行检测，以临床综合诊断为金标准，计算Xpert MTB/RIF方法检测结核分枝杆菌的敏感度和特异度。评估Xpert MTB/RIF与病理检查及BACTEC MGIT 960液体快速培养诊断效能。以药敏试验为金标准，计算Xpert MTB/RIF检出利福平耐药的敏感度。结果：100例疑似病例中最后临床确诊88例淋巴结结核。以最后临床确诊的88例淋巴结结核病例为金标准，Xpert检测、病理及960液体培养检出结核分支杆菌的敏感度分别为95.45%（84/88）,69.32%(61/88)和 23.86%(21/88)，特异度为100%（12/12）,100%(12/12)及91.67%（11/12）。Xpert检测的敏感度明显高于病理（χ2=20.711，P＜0.01）和960快速培养（χ2=93.701，P＜0.01）。在药敏试验证实的5例利福平耐药中，Xpert全部检测出rpoB基因突变，检测敏感度为100%（5/5）。结论：Xpert MTB/RIF方法在诊断淋巴结结核中具有较高的诊断效能，尤其是在病理疑似和菌阴性淋巴结结核的诊断中具有特殊优势。 |
| 英文摘要: |
| Objective: To explore the Diagnostic value of Xpert MTB/RIF assay in patients with suspected tuberculous lymphadenitis(TBL) . Methods: The 100 specimens were obtained from patients with suspected tuberculous lymphadenitis. All of the specimens were detected by Xpert MTB/RIF assay , pathological examination, and liquid fast culture by BACTEC MGIT 960. The results of Xpert test were compared to those of pathological examination, culture and drug susceptibility testing. Results: Among 100 suspected TBL patients, 88 patients were finally diagnosed with TBL. In those confirmed patients, Xpert test achieved higher sensitivity (95.45%) than those of pathological examination(69.32%)（X2=20.711，P＜0.01） and liquid fast culture (23.86%)（X2=93.701，P＜0.01）. Among 12 nontuberculosis patients, There were no positive results detected by Xpert MTB/RIF assay and pathological examination . There was a positive case in liquid fast culture identified as non-tuberculous mycobacteria(NTM). Xpert test detected 5 rifampicin resistance out of 5 rifampicin resistance confirmed by drug susceptibility testing. Conclusions: Xpert test showed a high sensitivity and specificity for the diagnosis of TBL, and the method is superior to pathological examination and liquid fast culture especially in those patients with suspected pathologically result and bacterial-negative TBL. |
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