河北医科大学学报

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Xpert MTB/RIF技术在疑似脊柱结核早期诊断及利福平耐药检测中的价值研究

  

  1. 1.河北省胸科医院骨科，河北 石家庄 050041；2.河北省胸科医院影像科，河北 石家庄 050041
  • 出版日期:2018-09-25 发布日期:2018-08-28
  • 作者简介:贾晨光（1975-），女，河北唐县人，河北省胸科医院主任医师，医学硕士，从事骨结核疾病诊治研究。
  • 基金资助:
    河北省科技计划项目（18277764D）

The value of Xpert MTB/RIF in the early diagnosis of suspected spinal tuberculosis and the detection of rifampicin resistance#br#

  1. 1.Department of Orthopedics， Hebei Chest Hospital，  Shijiazhuang 050041, China；
    2.Department of Medical Imaging, Hebei Chest Hospital， Shijiazhuang 050041, China
  • Online:2018-09-25 Published:2018-08-28

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摘要： ［摘要］〓
〖HTH〗目的〖HTSS〗〖KG*2〗评估Xpert MTB/RIF技术在疑似脊柱结核早期诊断及耐药中的应用价值。
〖HTH〗方法〖HTSS〗〖KG*2〗应用Xpert MTB/RIF系统对168例疑似脊柱结核术中脓液标本进行检测，以临床诊断为金标准，计算Xpert MTB/RIF检测结核分枝杆菌的敏感度、特异度，并比较与抗酸染色、结核分枝杆菌快速培养敏感度、特异度的差异。
〖HTH〗结果〖HTSS〗〖KG*2〗168例脊柱结核患者术中脓液标本中，134例Xpert MTB/RIF检测结核分枝杆菌阳性，其中利福平耐药25例。以临床诊断为金标准， Xpert MTB/RIF检测结核分枝杆菌的敏感度为79.76%（134/168），特异度为96.87%（47/50）。 在134例脊柱结核脓液标本中存在利福平耐药突变基因25例，耐药突变率为18.66%。168例脊柱结核患者脓液标本中，抗酸染色阳性51例，结核分枝杆菌快速培养阳性70例。
〖HTH〗结论〖HTSS〗〖KG*2〗Xpert  MTB/RIF是一种能够同时对脊柱结核行结核分枝杆菌与利福平耐药性检测的分子检测技术，在脊柱结核的快速诊断中具有较高的诊断价值。

关键词: 结核, 脊柱, 诊断, 耐药

Abstract: ［Abstract］〓Objective〖HTSS〗〓To assess the value of Xpert MTB/RIF in the early diagnosis and drug resistance of suspected spinal tuberculosis.
〖HTH〗〖WTHZ〗Methods〖HTSS〗〓Appling the Xpert MTB/RIF system to detect pus specimens from 168 suspected spinal tuberculosis surgery. Taking clinical diagnosis as the gold standard，the sensitivity and specificity of Xpert MTB/RIF for detection of Mycobacterium tuberculosis were calculated, and the differences in sensitivity and specificity between acidfast staining and rapid culture of Mycobacterium tuberculosis were compared.
〖HTH〗〖WTHZ〗Results〖HTSS〗〓In the pus specimens of 168 patients with spinal tuberculosis, 134 cases of Xpert MTB/RIF were positive for Mycobacterium tuberculosis, of which 25 cases were resistant to rifampicin.Clinical diagnosis as the gold standard，the sensitivity of Xpert MTB/RIF for detecting Mycobacterium tuberculosis was 79.76%(134/168) and the specificity was 96.87%(47/50).There were 25 rifampicinresistant mutant genes in 134 cases of spinal tuberculous pus, and the drugresistant mutation rate was 18.66%. In the pus specimens of 168 patients with spinal tuberculosis, 51 cases were positive for acidfast staining  and 70 cases were positive for rapid culture of Mycobacterium tuberculosis.
〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓Xpert MTB/RIF is a molecular detection technique that can simultaneously detect mycobacterium tuberculosis and rifampicin resistance in spinal tuberculosis.It has high diagnostic value in the rapid diagnosis of spinal tuberculosis.

Key words: tuberculosis, spinal； diagnosis； resistance

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