作　　者： (陈蕾）;

机构地区： 成都市公共卫生临床医疗中心（净居寺院区）,四川成都610000

出　　处： 《临床肺科杂志》 2017年第10期1879-1883,共5页

摘　　要： 目的探讨基因芯片技术在肺结核诊断中的应用价值。方法采集641例肺结核患者的痰及纤支镜冲洗液标本,同时进行抗酸染色法、MGIT液体培养法+微孔板比例法药物敏感性试验((简称"药敏试验")及基因芯片法检测,分析不同方法检测结核分枝杆菌(Mtb)及其异烟肼、利福平耐药性的敏感度、特异度、阳性预测值、阴性预测值和kappa值。不同方法之间Mtb及耐异烟肼、耐利福平、耐多药阳性检出率的比较采用χ2检验,P<0.05为差异有统计学意义。结果基因芯片法敏感度、特异度、阳性预测值、阴性预测值和kappa值均较高。基因芯片法Mtb阳性检出率54.91%高于涂片法27.61%,与液体培养法60.06%比较差异无统计学意义。基因芯片法和药敏试验检测Mtb耐异烟肼、耐利福平、耐多药阳性检出率,两者比较差异无统计学意义。结论基因芯片法在检测Mtb及其耐药性方面与传统液体培养法和药敏试验相比,有较高的敏感度和特异度,检测时间短,一致性高,值得临床应用推广。 Objective To explore the application value of gene chip technology in diagnosis of pulmonary tu-berculosis. Methods The data of 641 cases of pulmonary tuberculosis patients with sputum and bronchoscopic lav-age specimens were detected by acid fast stain, MGIT liquid （ （ hereinafter referred to as ＂ drug sensitive test＂ ） de-tection and gene chip method. Their drug sensitivity, specificity, positive predictive value, negative predictive value and Kappa value of Mycobacterium tuberculosis （ Mtb） , isoniazid and rifampicin were analyzed, and the results were analyzed by X2 test among different groups. P 〈 0. 05 difference was statistically significant. Results The sensitivi-ty, specificity, positive predictive value, negative predictive value and Kappa value were higher for gene chip meth-od. The positive rate of Mtb was 54. 91% in the gene chip group, which was higher than 27. 61% of the smear meth-od group （ P 〈 0. 05 ） and similar with 60. 06% of the liquid culture method group. There was no significant differ-ence in the positive rate of isoniazid, rifampin and multi-drug resistance of Mtb between the gene chip group and the drug sensitive test group. Conclusion Gene chip method has high sensitivity and specificity and consistency in de-tection of Mtb and its drug resistance, which is worthy of widely clinical application.

关 键 词： 基因芯片技术 肺 结核分枝杆菌 诊断