| Xpert MTB/RIF在脊柱结核诊断及利福平耐药检测中的应用价值 |
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Received:November 22, 2016
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| 作者 | Author | 单位 | Unit | E-Mail |
| 金阳辉 |
JIN Yang-hui |
浙江中医药大学附属中西医结合医院骨科, 浙江 杭州 310003 |
Department of Orthopaedics, Integrated Chinese and Western Medicine Hospital of Zhejiang Chinese Medical University, Hangzhou 310003, Zhejiang, China |
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| 石仕元 |
SHI Shi-yuan |
浙江中医药大学附属中西医结合医院骨科, 浙江 杭州 310003 |
Department of Orthopaedics, Integrated Chinese and Western Medicine Hospital of Zhejiang Chinese Medical University, Hangzhou 310003, Zhejiang, China |
ssylf@sina.com |
| 郑琦 |
ZHENG Qi |
浙江中医药大学附属中西医结合医院骨科, 浙江 杭州 310003 |
Department of Orthopaedics, Integrated Chinese and Western Medicine Hospital of Zhejiang Chinese Medical University, Hangzhou 310003, Zhejiang, China |
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| 沈健 |
SHEN Jian |
浙江中医药大学附属中西医结合医院骨科, 浙江 杭州 310003 |
Department of Orthopaedics, Integrated Chinese and Western Medicine Hospital of Zhejiang Chinese Medical University, Hangzhou 310003, Zhejiang, China |
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| 应小樟 |
YING Xiao-zhang |
浙江中医药大学附属中西医结合医院骨科, 浙江 杭州 310003 |
Department of Orthopaedics, Integrated Chinese and Western Medicine Hospital of Zhejiang Chinese Medical University, Hangzhou 310003, Zhejiang, China |
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| 汪翼凡 |
WANG Yi-fan |
浙江中医药大学附属中西医结合医院骨科, 浙江 杭州 310003 |
Department of Orthopaedics, Integrated Chinese and Western Medicine Hospital of Zhejiang Chinese Medical University, Hangzhou 310003, Zhejiang, China |
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| 期刊信息：《中国骨伤》2017年30卷，第9期，第787-791页 |
| DOI：10.3969/j.issn.1003-0034.2017.09.002 |
| 基金项目:杭州市科委引导项目（编号：2014YD14） |
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目的：探讨Xpert MTB/RIF技术在脊柱结核诊断及利福平耐药检测中的应用价值。
方法：选取109例初步诊断为脊柱结核患者的脓液标本，分别行抗酸染色、BACTEC MGIT 960液体快速培养和Xpert MTB/RIF试验，对比3种检测结核分枝杆菌的敏感性及特异性的差异。对不同方法获取的脓液标本行Xpert MTB/RIF检测，评估脓液标本本身对Xpert MTB/RIF检测结核分枝杆菌效能的影响。以BACTEC MGIT 960液体快速培养药敏试验结果为金标准，分析Xpert MTB/RIF检测利福平耐药的效能。
结果：抗酸染色、BACTEC MGIT 960液体快速培养及Xpert MTB/RIF检测的总体敏感性分别为25.92%、48.15%和77.78%.Xpert MTB/RIF检测开放手术、B超定位穿刺和穿刺活检取得脓液标本的敏感性分别为83.78%、76.47%和44.68%.以BACTEC MGIT 960液体快速培养药敏试验结果为金标准，Xpert MTB/RIF检测利福平耐药的敏感性和特异度分别为80%（4/5）和90.70%（39/43）.
结论：Xpert MTB/RIF试验对脊柱结核具有较高的诊断价值，同时能对利福平耐药菌株进行检测，脓液标本中结核分枝杆菌含量对Xpert MTB/RIF检测的敏感性影响较大。 |
| [关键词]:Xpert MTB/RIF 结核，脊柱 诊断 利福平 |
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| Application value of Xpert MTB/RIF in diagnosis of spinal tuberculosis and detection of rifampin resistance |
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Abstract:
Objective: To investigate the application value of Xpert MTB/RIF in diagnosis of spinal tuberculosis and detection of rifampin resistance.
Methods: The 109 pus specimens were obtained from patients who were primaryly diagnosed as spinal tuberculosis. All of the pus specimens were detected by acid-fast stain,liquid fast culturing by BACTEC MGIT 960 and Xpert MTB/RIF assay to definite the differences in sensitivity and specificity of mycobacterium tuberculosis among detecting methods. Pus specimens obtained by different methods were deteceded by MTB/RIF test to analyze the self-influence on Xpert MTB/RIF test. The result of liquid fast culturing by BACTEC MGIT 960 was used as the gold standard;and the value of Xpert MTB/RIF assay in detecting rifampin resistance was analyzed.
Results: The sensitivity of acid-fast stain,liquid fast culturing by BACTEC MGIT 960 and Xpert MTB/RIF assay were 25.92%,48.15%,77.78%,respectively. The sensitivity of pus specimens obtained from open surgery,ultrasound positioning puncture and biopsy the sensitivity were 83.78%,76.47%,44.68% respectively deteceded by MTB/RIF test. According to the gold standard of the results of liquid fast culturing by BACTEC MGIT 960 assay,the sensitivity and specificity of Xpert MTB/RIF assay in detecting rifampin resistance were 80%(4/5) and 90.70%(39/43),respectively.
Conclusion: Xpert MTB/RIF assay has higher value in diagnosis of spinal tuberculosi,and also can detect rifampin resistance. The number of mycobacterium tuberculosis in pus specimens has a great influence in the sensitivity of Xpert MTB/RIF assay. |
| KEYWORDS:Xpert MTB/RIF Tuberculosis,spinal Diagnosis Rifampin |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 金阳辉,石仕元,郑琦,沈健,应小樟,汪翼凡.Xpert MTB/RIF在脊柱结核诊断及利福平耐药检测中的应用价值[J].中国骨伤,2017,30(9):787~791 |
| 英文格式: | JIN Yang-hui,SHI Shi-yuan,ZHENG Qi,SHEN Jian,YING Xiao-zhang,WANG Yi-fan.Application value of Xpert MTB/RIF in diagnosis of spinal tuberculosis and detection of rifampin resistance[J].zhongguo gu shang / China J Orthop Trauma ,2017,30(9):787~791 |
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