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目的探讨GeneXpert MTB/RIF技术在结核性胸膜炎诊断及利福平耐药检测中的应用价值。方法收集结核性胸膜炎369例患者胸腔积液,利用集菌涂片法、结核分枝杆菌培养法和GeneXpert MTB/RIF法3种方法检测,对其阳性率进行比较;并对培养阳性菌株采用比例法检测利福平的药敏情况,结果与GeneXpert MTB/RIF法对比。结果 369例胸腔积液集菌涂片法、结核分枝杆菌培养法和GeneXpert MTB/RIF法阳性检出率分别为14.6%(54/369)、16.5%(61/369)和77%(284/369),GeneXpert MTB/RIF法和涂片法、培养法方法比较,差异有统计学意义(χ~2=288.76、270.68,P<0.01)。GeneXpert MTB/RIF法特异度为100%,敏感度为77%。369例标本采用结核分枝杆菌培养法测得阳性为61例,分别取其菌落用比例法检测利福平耐药情况,结果与GeneXpert MTB/RIF法检测结果一致。结论GeneXpert MTB/RIF技术操作简便、快速、安全,敏感度和特异度较高,对早期诊断结核性胸膜炎以及判定利福平的耐药情况具有较大价值。
Objective To investigate the value of GeneXpert MTB / RIF in the diagnosis of tuberculous pleurisy and the determination of rifampicin resistance. Methods The pleural effusion of 369 patients with tuberculous pleurisy was collected. The positive rate was tested by the methods of bacterial smear, Mycobacterium tuberculosis and GeneXpert MTB / RIF. Method to detect rifampicin susceptibility, the results and GeneXpert MTB / RIF method. Results The positive rates of 369 pleural effusion bacterial smear tests, MTB culture and GeneXpert MTB / RIF assays were 14.6% (54/369), 16.5% (61/369) and 77% (284) / 369). The difference between GeneXpert MTB / RIF and smear and culture methods was statistically significant (χ ~ 2 = 288.76, 270.68, P <0.01). GeneXpert MTB / RIF has a specificity of 100% and a sensitivity of 77%. 369 specimens were tested positive by MTB culture method, 61 cases were detected by the proportion of colonies with rifampicin resistance, the results and GeneXpert MTB / RIF test results. Conclusion The GeneXpert MTB / RIF technique is simple, rapid, safe, sensitive and specific. It has great value in the early diagnosis of tuberculous pleurisy and the determination of resistance to rifampicin.