| 摘要: |
| 目的探讨肺泡灌洗液结核杆菌利福平耐药基因（XpertMTB/RIF）检测在痰涂片阴性（涂阴）肺结核早期诊断中的应用价值。方法选取157例涂阴肺结核患者为观察组，56例排除结核病的患者为对照组，收集肺泡灌洗液进行抗酸染色涂片、分枝杆菌液体培养及XpertMTB/RIF检测，比较两组患者XpertMTB/RIF检测阳性率以及观察组3种检测方法的阳性率；并以分枝杆菌液体培养药敏试验结果为金标准，评价XpertMTB/RIF检测诊断利福平耐药的效能。结果观察组肺泡灌洗液XpertMTB/RIF检测阳性率为73.9%，明显高于对照组的1.8%（P＜0.05）。观察组患者肺泡灌洗液抗酸染色涂片、分枝杆菌液体培养及XpertMTB/RIF检测阳性率分别为20.4%、38.9%和73.9%；经两两比较，XpertMTB/RIF检测法＞分枝杆菌液体培养法＞抗酸染色涂片法，差异均有统计学意义（均P＜0.05）。XpertMTB/RIF检测诊断利福平耐药的灵敏度为100.0%，特异度为98.0%；两者一致性较好。结论肺泡灌洗液XpertMTB/RIF检测诊断涂阴肺结核的灵敏度和特异度均较高，建议在该类患者中开展肺泡灌洗液XpertMTB/RIF检测。 |
| 关键词: 肺结核 肺泡灌洗液 Xpert MTB/RIF 检测 |
| DOI：10.12056/j.issn.1006-2785.2017.40.8.2017-788 |
| 分类号: |
| 基金项目:湖州市科技局公益性重点科技计划项目（2014GZ10） |
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| Detection of Xpert MTB/RIF in bronchoalveolar lavage fluid for diagnosis of smear-negative pulmonary tuberculosis |
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Huzhou Central Hospital
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| Abstract: |
| Objective To evaluate the detection of Xpert MTB/RIF in bronchoalveolar lavage fluid (BALF) for the early diagnosis of smear-negative pulmonary tuberculosis. Methods The BALF samples were obtained from 157 cases of smear negative pulmonary tuberculosis (study group) and 56 non-pulmonary tuberculosis patients (control group). The acid fast staining, mycobacterium liquid culture and Xpert MTB/RIF detection in BALF were performed in two groups, and the positive rates of three detection methods in study group were compared. Results The Xpert MTB/RIF positive rate in BALF of study group was significantly higher than that of control group (73.9% vs. 1.8%, P ＜0.05). The positive rates of anti acid staining smear, mycobacterium liquid culture and Xpert MTB/RIF in the study group were 20.4%, 38.9% and 73.9%, respectively (P＜0.05). With the mycobacterium liquid culture drug sensitivity test as the gold standard, the sensitivity and specificity of Xpert/MTB/RIF for
detection of resistance to rifampin was 100.0% and 98.0% , respectively. Conclusion The detection of Xpert MTB/RIF in bronchoalveolar lavage fluid has high sensitivity and specificity in diagnosis of smear-negative pulmonary tuberculosis. |
| Key words: Pulmonary tuberculosis Bronchoalveolar lavage fluid Xpert MTB/RIF detection |
