【摘要】 目的基因检测结核分枝杆菌耐药与液体培养法、术后病理的一致性与否的临床研究。方法选取2019年1月-2020年12月吉林省结核病医院收治的结核性脓胸患者118例病例,行胸膜剥脱术术中留取胸膜组织行结核分枝杆菌耐药检测PCR检测阳性的为86例;同时证实为结核分枝杆菌,运用培养法、PCR熔解曲线法分别检测分离86例患者结核分枝杆菌菌株中R、H、E、S、喹诺酮类耐药情况,然后对特异度和敏感性进行计算,与术后病理比较;比较两种病原学及与病理学检测的符合率。结果 PCR检测,阳性率为72.88%。其中H的特异度以及灵敏度分别为93.9%、85.4%;检测R特异度及灵敏度分别为97.1%、92.3%;E特异度及灵敏度分别为85.74%、92.53%;S特异度及灵敏度分别为89.67%、92.68%;喹诺酮类特异度及灵敏度分为93.65%、96.24%;两种方法的符合率差异比较无差异(P>0.05)。结论胸膜组织行结核性分枝杆菌耐药基因检测PCR检查结果较为可靠,对结核性脓胸的早诊断、早用药具有较好的指导作用。更多还原

【Abstract】 Objective Clinical study on the consistency of gene detection of Mycobacterium tuberculosis drug resistance with liquid culture method and postoperative pathology.Methods A total of 118 patients with tuberculous empyema admitted to our hospital from January 2019 to December 2020 were selected.Among them,86 patients were positive for drug resistance detection of Mycobacterium tuberculosis by PCR after pleural tissue was retained during pleural stripping operation.At the same time,the patients were confirmed to be Mycobacterium tuberculosis.The R,H,E,S and quinolone resistance in Mycobacterium tuberculosis isolates of 86 patients were detected by culture method and PCR dissolution curve method,and then the specificity and sensitivity were calculated and compared with postoperative pathology.The coincidence rates of etiology and pathology were compared.Results The positive rate was 72.88% by PCR.The specificity and sensitivity of H were 93.9% and 85.4%,respectively.The specificity and sensitivity of R were 97.1% and 92.3%,respectively.E specificity and sensitivity are 85.74% and 92.53%,respectively.S specificity and sensitivity are 89.67% and 92.68%,respectively.The specificity and sensitivity of quinolones are divided into 93.65% and 96.24%.There was no significant difference in coincidence rate between the two methods (P>0.05).Conclusion PCR detection of drug resistance gene of Mycobacterium tuberculosis in pleural tissue is more reliable,which has a better guiding role in the early diagnosis and early medication of tuberculosis empyema.更多还原