基因芯片技术检测分枝杆菌和异烟肼、利福平耐药性在结核性脓胸诊断中的应用

发布时间：2018-04-14 19:47

本文选题：基因芯片 + 分枝杆菌　；参考：《中国人兽共患病学报》2017年08期

【摘要】：目的探讨基因芯片技术检测分枝杆菌和异烟肼(INH)、利福平(RFP)耐药性在结核性脓胸诊断中的临床应用价值。方法收集2011年1月至2015年12月临床疑似结核性脓胸患者182例的脓液标本,分别应用基因芯片技术和快速培养法进行检测,比较两种方法的特异性和敏感性;同时选取36例临床确诊为结核性脓胸患者,且基因芯片法和MGIT培养法均为阳性的标本进行INH、RFP耐药性检测。以MGIT培养法的药敏结果为标准,评价基因芯片法的灵敏度、特异度和符合率。结果 182例疑似结核性脓胸患者中,135例临床确诊为结核性脓胸,基因芯片法和快速培养法的特异性均为95.7%(45/47),灵敏度分别为48.9%(66/135)和26.7%(36/135),二者比较有统计学差异(χ2=80.5,P0.05)。基因芯片法检测RFP耐药性灵敏度、特异度和符合率均为100%;而检测INH耐药性的灵敏度、特异度和符合率分别为50.0%(1/2)和97.1%(33/34)和94.4%。结论基因芯片技术检测分枝杆菌具有较高的、特异性,可快速鉴别出非结核分枝杆菌,且可有效检测结核分枝杆菌异烟肼和利福平的耐药性,对结核性脓胸的早期诊断与治疗有重要意义。
[Abstract]:Objective to investigate the clinical application value of gene chip technique in the diagnosis of tuberculous empyema by detecting the resistance of Mycobacterium isoniazide (INHN) and rifampicin (rifampicin) in the diagnosis of tuberculous empyema.Methods 182 patients with suspected tuberculous empyema were collected from January 2011 to December 2015. The specificity and sensitivity of the two methods were compared by gene chip technique and rapid culture method.At the same time, 36 patients with tuberculous empyema were tested for drug resistance by gene chip method and MGIT culture method.The sensitivity, specificity and coincidence rate of gene chip assay were evaluated according to the drug sensitivity of MGIT culture method.Results among 182 suspected tuberculous empyema patients, 135 cases were clinically diagnosed as tuberculous empyema. The specificity of gene chip method and rapid culture method were 95.745 / 47, the sensitivity was 48.9% / 135) and 26.775% 36 / 135% respectively. There was a statistical difference between the two methods (蠂 2 80.5% P 0.05).The sensitivity, specificity and coincidence rate of RFP resistance detected by gene chip method were 100, while the sensitivity, specificity and coincidence rate of detecting INH resistance were 50.01 / 2) and 97.1g / 34) and 94.4%, respectively.Conclusion the detection of Mycobacterium tuberculosis by gene chip technique has a high specificity and can be used to identify non-tuberculous mycobacteria quickly and to detect the resistance of isoniazid and rifampicin to Mycobacterium tuberculosis.It is important for the early diagnosis and treatment of tuberculous empyema.
【作者单位】：福建医科大学福州总医院临床医学院呼吸与危重症医学科;福建中医药大学附属第三人民医院;福建医科大学教学医院福州肺科医院检验科;福建省疾病预防控制中心;福建医科大学教学医院福州肺科医院结核科;
【基金】：福建省卫生和计划生育委员会青年科研课题(No.2014-1-74)~~
【分类号】：R521.7

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