【摘要】 目的研究无痰、菌阴肺结核患者应用结核分枝杆菌(MTB)/利福平(RIF)耐药实时荧光定量核酸扩增技术(Xpert MTB/RIF)的检测效果及其应用价值。方法选取2019年1月至2020年10月清远市人民医院收治的56例疑似无痰、菌阴肺结核患者作为研究对象,所有患者入院后均行痰涂片抗酸染色检查,三次痰液涂片均呈阴性;无痰或少痰患者影像学检测判断。之后对患者进行支气管镜检查并进行肺泡灌洗,收集肺泡灌洗液后分成3份(5 ml/份)同时行抗酸杆菌涂片、结核分支杆菌复合群DNA及Xpert MTB/RIF检测,比较三种检测方式的的准确性及临床应用价值。结果 Xpert MTB/RIF技术检测的灵敏度、阳性预测值及阴性预测值均高于结核分支杆菌复合群DNA检测及抗酸涂片检测,特异度高于结核分支杆菌复合群DNA检测,差异有统计学意义(P<0.05)。结论 Xpert MTB/RIF技术应用于结核分枝杆菌阴肺结核患者的临床检测和药敏实验检测具有重要作用,有利于患者早期诊断及治疗方案的确定,具有极高的临床应用价值。更多还原

【Abstract】 Objective To study the detection effect and application value of mycobacterium tuberculosis(MTB)/Rifampin(RIF) resistant real-time fluorescent quantitative nucleic acid amplification(Xpert MTB/RIF) in patients with non sputum and bacterial negative pulmonary tuberculosis. Methods A total of 56 patients with suspected sputum free and bacterial negative pulmonary tuberculosis admitted to Qingyuan People’s Hospital from January 2019 to October2020 were selected as the research objects. After admission, all patients underwent sputum smear acid fast staining examination, and sputum smear was negative for three times. According to imaging detection, patients with no sputum or less sputum underwent bronchoscopy and alveolar lavage, after collecting the bronchoalveolar lavage fluid, they were divided into 3 parts(5 ml/part) and detected by acid fast bacilli smear, Mycobacterium tuberculosis complex DNA and xpert MTB/RIF at the same time. Results The sensitivity, positive predictive value and negative predictive value of Xpert MTB/RIF technology detection were higher than those of Mycobacterium tuberculosis complex DNA detection and acid-fast smear detection, and the specificity is higher than that of Mycobacterium tuberculosis complex DNA detection, and the differences were statistically significant(P<0.05). Conclusion Xpert MTB/RIF technology plays an important role in the clinical detection and drug sensitivity test of Mycobacterium tuberculosis negative pulmonary tuberculosis patients, which is conducive to the early diagnosis and treatment of patients, and has high clinical application value.更多还原