摘要
目的评估Gene Xpert MTB/RIF检测在临床早期诊断结核性脑膜炎中的应用价值。方法选取2015-10—2017-03内蒙古自治区第四医院收治的86例临床诊断为结核性脑膜炎患者及同期32例非结核脑膜炎患者,对所有患者行Gene Xpert MTB/RIF检测、实时荧光定量PCR、脑脊液抗酸染色及脑脊液结核杆菌培养试验检测,观察各种检测方法患者阳性检出率,计算各检测方法敏感度、特异性及符合率等指标。结果脑脊液Gene Xpert MTB/RIF检测的敏感度、特异性、符合率、阳行预测值及阴性预测值分别为69.9%(60/86)、100%(32/32)、77.9%(92/118)、100%(60/60)、55.2%(32/58),符合率高于其他3种检测技术,与抗酸染色涂片及结核分枝杆菌培养比较差异有统计学意义(P<0.05);脑脊液Gene Xpert MTB/RIF检测具有较好的诊断价值(Kappa=0.792,P<0.01)。结论相对于抗酸染色涂片、结核分枝杆菌培养以及FQ-PCR,Gene Xpert MTB/RIF检测法在诊断TBM方面有更为显著的优势,能够有效帮助临床医生对疑似TBM的患者进行早期诊断。
Objective To evaluate the value of Gene Xpert MTB / RIF detection in the early diagnosis of tuberculous meningitis. Methods The clinical data of 86 patients with tuberculous meningitis who were diagnosed in our hospital from October 2015 to March 2017 were analyzed retrospectively,and the clinical data of 32 patients with non tuberculous meningitis in the same period were selected.Gene Xpert MTB/RIF detection,real time fluorescence quantitative PCR,cerebrospinal fluid anti acid staining and cerebrospinal fluid culture test were performed to observe the positive rate of patients under various detection methods,and calculate the sensitivity,specificity and coincidence rate of each test method. Results CSF Gene Xpert MTB/RIF detection of sensitivity,specificity,coincidence rateaccuracy,positive predictive value and negative predictive value were respectively 69.9% （60/86）,100% （32/32）,77.9% （92/118）,100% （60/60）,55.2% （32/58）,the coincidence rate is higher than the other 3 kinds of detection technology,and with acid fast staining the difference of smear and cultivation of Mycobacterium tuberculosis has statistical significance （ P 〈0.05）;has good diagnostic value of cerebrospinal fluid Xpert detection of MTB/RIF （Kappa=0.792, P 〈0.01）.the coincidence rate was higher than the other three detection techniques,and the difference was statistically significant compared with the acid resistant staining smear and Mycobacterium tuberculosis culture （ P 〈0.05）.Cerebrospinal fluid Gene Xpert MTB/RIF has a good diagnostic value （Kappa=0.792, P 〈0.01）. Conclusion Gene Xpert MTB/RIF assay compared with acid fast staining and culture images of Mycobacterium tuberculosis and FQ PCR has a more significant advantage in the diagnosis of TBM,which can help clinicians early diagnosis of suspected TBM patients effectively.Compared with acid resistant stain smears,Mycobacterium tuberculosis culture,and FQ PCR,Gene Xpert MTB/RIF detection has a more significant advantage in the diagnosis of TBM,which can help clinicians to make early diagnosis of suspected TBM patients.
作者
金慧芳
刘鑫
JIN Huifang;LIU Xin(Department of Internal Medicine,Inner Mongolia NO.4 Hospital,Hohhot 010080,China;Department of Chest Surgery,nner Mongolia NO.4 Hospital,Hohhot 010080,China)
出处
《中国实用神经疾病杂志》
2018年第14期1557-1561,共5页
Chinese Journal of Practical Nervous Diseases
