【摘要】 目的评价结核分枝杆菌rpob基因和突变检测技术(Xpert MTB/RIF)、结核杆菌固体培养与抗酸染色镜检对泌尿系结核的诊断效能及其一致性。方法采用随机双盲、"金标准"对照的临床诊断实验设计,收集临床泌尿系结核可疑患者163例的晨尿,分别应用Xpert MTB/RIF、结核杆菌固体培养与抗酸染色镜检进行检测。以临床综合诊断作为泌尿系结核诊断的"金标准",评价3种检测方法的诊断效能并比较其检测结果的一致性。结果 163例患者尿标本使用Xpert MTB/RIF检出结核阳性51例(31.29%),结核杆菌固体培养法检出结核阳性40例(24.54%),抗酸染色镜检检出结核阳性39例(23.93%)。与"金标准"临床诊断泌尿系结核诊断比较,Xpert MTB/RIF检测和结核杆菌固体培养具有极高的一致性,抗酸染色镜检的一致性较弱。结论3种实验室检测方法均适用于临床泌尿系结核的诊断,其中结核杆菌固体培养法与临床综合诊断法具有更高的一致性。Xpert MTB/RIF不仅具有高度的一致性而且具有更高的灵敏度,适用于泌尿系结核的快速诊断。更多还原

【Abstract】 Objective To evaluate the diagnostic efficacy and consistency of rpoB gene and mutation detection technology(Xpert MTB/RIF),solid culture of Mycobacterium tuberculosis and acid-fast staining microscopy in urinary tuberculosis.Methods A randomized,double-blind,gold standard-controlled clinical diagnostic experimental method was designed.Totally 163 cases of suspected urinary tuberculosis patient urine were collected in the morning,Xpert MTB/RIF,solid culture of Mycobacterium tuberculosis and acid-fast staining microscopy were used for detection.Clinical diagnosis was used as gold standard of urinary tuberculosis diagnosis,to evaluate the consistency and diagnosis efficiency of other methods.Results In 163 patients urine,51 cases(31.29%)were positive detected by Xpert MTB/RIF,40 cases(24.54%)were positive by solid culture and 39 cases(23.93%)by acid-fast staining microscopy.Compared with the"gold standard"clinical diagnosis of urinary tuberculosis,Xpert MTB/RIF test and Mycobacterium tuberculosis solid culture had a very high consistency,but the acid-fast staining microscopy had a very weak consistency.Conclusion All the three laboratory tests are suitable for clinical diagnosis of urinary tuberculosis,and the solid culture method of tuberculosis bacillus is more consistent with the comprehensive clinical diagnosis method.Xpert MTB/RIF not only has high consistency but also has higher sensitivity.It is suitable for rapid diagnosis of urinary tuberculosis.更多还原