结核病与肺部健康杂志 ›› 2020, Vol. 9 ›› Issue (1): 55-57.doi: 10.3969/j.issn.2095-3755.2020.01.012

• 论著 • 上一篇    下一篇

基因芯片技术在肺结核快速诊断及分枝杆菌菌种鉴定中的应用价值

唐再庆, 唐明昊(), 朱晓琳, 刘玉琴()   

  1. 150500 哈尔滨,黑龙江省传染病防治院
  • 收稿日期:2019-12-10 出版日期:2020-03-30 发布日期:2020-04-17
  • 通信作者: 唐明昊,刘玉琴 E-mail:12023456787@qq.com;liuyuqin_ssy@163.com

Application value of gene chip technology in the rapid diagnosis of tuberculosis and the identification of mycobacterium

TANG Zai-qing, TANG Ming-hao(), ZHU Xiao-lin, LIU Yu-qin()   

  1. Infectious Disease Hospital of Heilongjiang Province, Harbin 150500, China
  • Received:2019-12-10 Online:2020-03-30 Published:2020-04-17
  • Contact: TANG Ming-hao,LIU Yu-qin E-mail:12023456787@qq.com;liuyuqin_ssy@163.com

摘要:

目的 探讨基因芯片技术诊断肺结核及鉴定分枝杆菌菌种的应用价值。方法 搜集2017年1—12月在黑龙江省传染病防治院结核科就诊并连续3次痰涂片检测为阳性的1248例疑似肺结核患者为研究对象。每例患者均留取清晨痰液标本3~5ml,对痰液标本分别进行BACTEC MGIT 960(简称“MGIT 960”)培养和基因芯片检测。以MGIT 960培养结果作为参照,分析基因芯片法的检测效能。结果 1248例患者痰标本经MGIT 960培养阳性1224例(98.08%),基因芯片法检测阳性1212例(97.11%)。以MGIT 960培养结果作为参照,基因芯片法检测的敏感度为98.94%(1211/1224),特异度为95.83%(23/24),符合率为98.88%(1234/1248),Kappa值为0.76。1212例基因芯片法检测阳性的患者中非结核分枝杆菌(NTM)感染60例(4.95%),结核分枝杆菌感染1152例(95.05%)。60例NTM感染者中比较常见的菌种是胞内分枝杆菌(43.33%,26/60)。结论 基因芯片检测与MGIT 960培养结果的一致性较好,可以快速、准确地区分结核分枝杆菌复合群和NTM,并可进一步进行菌种鉴定。

关键词: 分枝杆菌感染, 结核,肺, 基因, 芯片分析技术, 诊断, 数据说明,统计

Abstract:

Objective To explore the application value of gene chip technology in the diagnosis of pulmonary tuberculosis (PTB) and the identification of mycobacterium. Methods A total of 1248 patients with suspected PTB whose sputum smears were tested positive for three consecutive times were collected in Infections Disease Hospital of Heilongjiang Province from January 2017 to December 2017. The 3-5 ml of early morning sputum specimens were collected from each patient, and the samples were tested by culturing with BACTEC MGIT 960 (MGIT 960) and gene chip technology, respectively. MGIT 960 culturing was used as reference method to analyze the detection efficiency of gene chip technology. Results Among 1248 sputum specimens, 98.08% (1224/1248) sputum specimens were positive by culture method with MGIT 960, and 97.11% (1212/1248) were positive by gene chip technology. The sensitivity, specificity, coincidence rate and Kappa value of the gene chip method were 98.94% (1211/1224), 95.83% (23/24), 98.88% (1234/1248), and 0.76, respectively, compared with the MGIT 960 culture method which was regarded as a standard. Among the 1212 positive patients by gene chip method, 60 cases (4.95%) were infected with non-tuberculosis mycobacterium (NTM), and 1152 cases (95.05%) were infected with MTB. Among the 60 patients infected with NTM, the most common strain was Mycobacterium intracellularis (43.33%, 26/60). Conclusion The results of gene chip technology have good consistency with the results of MGIT 960 culture method, which can quickly and accurately distinguish between Mycobacterium tuberculosis complex and NTM, and can be used for future identification of mycobacterium.

Key words: Mycobacterium infections, Tuberculosis, pulmonary, Genes, Microchip analytical procedures, Diagnosis, Data interpretation, statistical