三种检测技术诊断老年肺结核效能的比较研究

探讨结核分枝杆菌及利福平耐药实时荧光定量核酸扩增(GeneXpert MTB/RIF)技术,发光二极管(light emitting diode,LED)荧光染色法和BACTEC MGIT 960系统液体培养(简称“MGIT液体培养”)诊断老年肺结核的价值。

Comparative study on the efficacy of three detection techniques in diagnosis of senile pulmonary tuberculosis

Objective To investigate the diagnostic value of Mycobacterium tuberculosis and rifampicin resis-tance real-time fluorescence quantitative nucleic acid amplification (GeneXpert MTB/RIF), light emitting diode (LED) fluorescence staining and BACTEC MGIT 960 system liquid culture (MGIT liquid culture) in elderly patients with pulmonary tuberculosis. A total of 250 elderly patients with pulmonary tuberculosis admitted to the Department of Pulmonary and Respiratory Infections of Shaoxing Municipal Hospital from 2013 to 2015 were collected. Among them, there were 159 males and 91 females, aged 65-89 years, with an average of (70.3±6.2) years. All of 250 sputum specimens were detected by LED fluorescence staining, MGIT liquid culture and GeneXpert MTB/RIF technique. The chi square test was used to compare between each group, and P<0.05 was considered statistically significant. The positive rates of LED fluorescence staining, MGIT liquid culture and GeneXpert MTB/RIF were 36.00% (90/250), 48.40% (121/250) and 50.40% (126/250) respectively. The positive rate of GeneXpert MTB/RIF (50.40%) was higher than that of LED fluorescence staining (36.00%) and the difference was statistically significant (χ²=10.56, P<0.01); and higher than that of MGIT liquid culture (48.40%), but the difference was not statistically significant (χ²=0.20, P>0.05); the positive rate of MGIT liquid culture (48.40%) was higher than that of LED fluorescence staining (36.00%). The difference was statistically significant (χ²=7.88, P<0.01). The sensitivity, specificity, positive predictive value and negative predictive value of GeneXpert MTB/RIF were 95.93% (118/123), 93.70% (119/127), 93.65% (118/126) and 95.97% (119/124) respectively, and the results of the two tests have excellent consistency (Kappa value was 0.90). Among the three detection technologies in this study, GeneXpert MTB/RIF has a higher detection efficiency, which is highly consistent with the results of MGIT liquid culture, and has a good clinical application and promotion value.