新发传染病电子杂志2026，Vol.11Issue(4)：13-17,5.DOI:10.19871/j.cnki.xfcrbzz.2026.04.002
利福平耐药实时荧光定量核酸扩增检测技术在结核病患者不同类型标本中的诊断效能评估
The diagnostic value of Xpert MTB/RIF detection in different types of samples of tuberculosis patients
摘要
Abstract
Objective This study aimed to evaluate the diagnostic performance of the GeneXpert Mycobacterium tuberculosis/rifampicin assay(Xpert MTB/RIF),a real-time fluorescent quantitative nucleic acid amplification test,in different clinical specimens from patients with active tuberculosis(TB),so as to provide evidence for specimen selection in clinical TB diagnosis.Method A retrospective analysis was performed.Clinical data and Xpert MTB/RIF test results of various specimens were collected from patients diagnosed with active TB at the Third People's Hospital of Shenzhen between January and December 2023.The positive detection rates across specimen types were statistically compared.Paired samples of bronchoalveolar lavage fluid(BALF)versus sputum,and tissue versus pus were analyzed for detection rate differences.The prevalence of rifampicin resistance was also compared between patients with newly treated TB and retreated TB.Result A total of 1,443 specimens were enrolled.The overall positive detection rate of Xpert MTB/RIF was 69.02%(996/1443).The positive rates of different specimens sorted in descending order were as follows:pus 89.11%(221/248),bronchoalveolar lavage fluid 84.50%(169/200),sputum 74.74%(361/483),tissue 71.42%(100/140),urine 56.96%(45/79),stool 42.86%(42/98),cerebrospinal fluid 34.14%(28/82),and pleural effusion 26.55%(30/113).Paired analysis for pulmonary TB patients revealed that the detection rate of BALF(87.90%,109/124)was significantly higher than that of sputum(67.74%,84/124),with a statistically significant difference(χ2=18.939,P＜0.001).For extrapulmonary TB patients,the detection rate of pus(86.76%,59/68)was markedly higher than that of tissue specimens(64.71%,44/68)(χ2=9.000,P=0.002).Rifampicin resistance testing showed an overall resistance rate of 8.59%(124/1443),including a resistance rate of 2.84%in newly treated TB patients and 5.75%in retreated TB patients.Conclusion Xpert MTB/RIF assay features rapid detection,simple operation,high specificity,and the capability to identify rifampicin resistance.However,its diagnostic yield varies substantially by specimen type.Targeted selection of clinical specimens can effectively improve the etiological diagnostic accuracy of tuberculosis.关键词
利福平耐药实时荧光定量核酸扩增检测技术/结核病/分子诊断/利福平耐药性/诊断效能/联合检测Key words
Xpert MTB/RIF/Tuberculosis/Molecular diagnosis/Rifampicin resistance/Diagnostic efficiency/Paired detection分类
医药卫生引用本文复制引用
张雅曦,李静,杨倩婷,王敏,詹森林,陈骑..利福平耐药实时荧光定量核酸扩增检测技术在结核病患者不同类型标本中的诊断效能评估[J].新发传染病电子杂志,2026,11(4):13-17,5.基金项目
国家自然科学基金面上项目(82172286,82372264) （82172286,82372264）
