| 吴小慧，刘为勇，汪峰，孙自镛.评估GeneXpert MTB / RIF技术在结核性脑膜炎
诊断中的价值[J].神经损伤功能重建,2018,13(7):344-347 |
| 评估GeneXpert MTB / RIF技术在结核性脑膜炎
诊断中的价值 |
| Evaluation of GeneXpert MTB/RIF for Diagnosis of Tuberculous Meningitis |
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| DOI： |
| 中文关键词: 结核性脑膜炎 脑脊液 GeneXpert MTB / RIF 诊断 |
| 英文关键词: tuberculous meningitis cerebrospinal fluid GeneXpert MTB/RIF diagnosis |
| 基金项目:国家重大传染病专
项
（2017ZX101030
05-007） |
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| 摘要点击次数: 2845 |
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| 中文摘要: |
| 目的：探讨GeneXpert MTB/RIF检测技术在结核性脑膜炎（TBM）诊断中的应用价值。方法：收集疑
似TBM患者137例，采集患者脑脊液标本，运用抗酸染色法、培养法、GeneXpert MTB/RIF技术进行检测。
分别以临床诊断和培养法作为参考标准来评价GeneXpert MTB/RIF对TBM的诊断性能。结果：137例患者
中最终纳入 124 例（90.5%），临床诊断为 TBM 51 例，非 TBM73 例。以临床诊断为标准，GeneXpert MTB/
RIF、抗酸染色法、培养法在TBM组检测敏感度分别为25.5%（13/51）、3.9%（2/51）、17.6%（9/51），特异性均为
100%（73/73）。GeneXpert MTB/RIF 敏感性与培养法相比无差异（P=0.336），但显著高于抗酸染色法（P=
0.002）。若以结核杆菌培养法作为参考标准，GeneXpert MTB/RIF检测TBM的敏感性为88.9%（8/9），特异
性为100%（73/73）。13例经GeneXpert MTB/RIF检测阳性患者中均未检出利福平耐药，与传统药敏结果一
致。结论：GeneXpert MTB/RIF技术操作简便、快速，特异性高。 |
| 英文摘要: |
| To evaluate the diagnostic value of GeneXpert MTB/RIF for diagnosis of tuberculous
meningitis (TBM). Methods: A total of 137 patients with suspected TBM were prospectively recruited. Samples
of cerebrospinal fluid were collected from all patients, and tested by acid fast staining, mycobacterial culture and
GeneXpert MTB/RIF. The performance of GeneXpert MTB/RIF was evaluated by two reference standards,
clinical diagnosis and mycobacterial culture, respectively. Results: Of the 137 enrolled subjects, 124 cases
(90.5% ) had a final diagnosis, with 51 cases being diagnosed definitive TBM and 73 cases being diagnosed
non-TBM. When clinical diagnosis was used as the reference standard, the sensitivities of GeneXpert MTB/RIFˎ
acid fast staining ˎ mycobacterial culture were 25.5% (13/51) ˎ 3.9% (2/51) ˎ 17.6% (9/51), respectively. The
specificities of the three methods were all 100%. The sensitivity of GeneXpert MTB/RIF was comparable to that
of mycobacterial culture (P=0.336), and was significantly higher than that of acid fast staining (P=0.002). When
mycobacterial culture was used as the reference standard, the sensitivity of GeneXpert MTB/RIF was 88.9%，and
specificity was 100% . Rifampin resistance was not found in the 13 positive results of GeneXpert MTB / RIF
assay, which was consistent with traditional drug susceptibility test. Conclusion: GeneXpert MTB / RIF is a
simple and rapid diagnostic method with high specificity for Mtb detection |
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