实用医学杂志 ›› 2020, Vol. 36 ›› Issue (24): 3416-3419.doi: 10.3969/j.issn.1006⁃5725.2020.24.022

• 医学检查与临床诊断 • 上一篇    下一篇

利福平耐药实时荧光定量核酸扩增检测技术及环介导等温扩增技术在结核性脑膜炎的诊断价值

冉燕, 赵建军, 张建勇, 宗兆婧   

  1. 遵义医科大学附属医院呼吸与危重症医学科结核病区(贵州遵义 563003)
  • 出版日期:2020-12-25 发布日期:2021-01-19
  • 通讯作者: 张建勇 E⁃mail:610559131@qq.com
  • 基金资助:
    贵州省科学技术厅课题(编号:黔科合 LH 字[2016]7487 号)

The diagnostic value of GeneXpert MTB/RIF and LAMP in tuberculous meningitis

RAN Yan,ZHAO Jian⁃jun,ZHANG Jianyong,ZONG Zhaojing
  

  1. Tuberculosis Ward,the Department of Respiratory and Critical Care Medi⁃cine,the Affiliated Hospital of Zunyi Medical University,Zunyi 563003,China
  • Online:2020-12-25 Published:2021-01-19
  • Contact: ZHANG Jianyong E⁃mail:610559131@qq.com

摘要:

目的 评价脑脊液利福平耐药实时荧光定量核酸扩增检测技术(GeneXpert MTB/RIF)及脑 脊液环介导等温扩增技术(LAMP)在结核性脑膜炎中的诊断价值。方法 收集临床诊断为结核性脑膜炎 住院患者 110 例,随机收集 60 例为结核性脑膜炎 A 组,50 例为结核性脑膜炎 B 组,另收集其他中枢神经系 统感染患者脑脊液 20 例为对照组(CG 组)。其中结核性脑膜炎 A 组患者入院后抽取脑脊液送脑脊液常 规、生化、结核菌涂片、结核菌培养、GeneXpert MTB/RIF,结核性脑膜炎 B 组患者送脑脊液作常规、生化、结核菌涂片、结核菌培养和 LAMP,CG 组患者送脑脊液作常规、生化、结核菌涂片、结核菌培养、GeneXpert MTB/RIF和LAMP。结果 结核性脑膜炎A组脑脊液GeneXpert MTB/RIF阳性32例,其中利福平耐药基因检 测阳性 3 例,结核性脑膜炎 A 组脑脊液结核菌涂片、培养、GeneXpert MTB/RIF 阳性率分别为 8.3%(5/60)、 16.7%(10/60)和 53.0%(32/60)。结核性脑膜炎 B 50 例脑脊液结核菌涂片、结核菌培养、LAMP,阳性率 分别为 8.0%(4/50),18.0%(9/50)和 58.0%(29/50),CG 组脑脊液 GeneXpert MTB/RIF 和脑脊液 LAMP 均为阴 性。结论 脑脊液GeneXpert MTB/RIF 及脑脊液LAMP 均为早期诊断结核性脑膜炎的较好方法。

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Abstract:

Objective To investigate the diagnostic value of cerebrospinal fluid GeneXpert MTB/RIF and cerebrospinal fluid LAMP for tuberculous meningitis. Methods Selected 110 cases of tuberculous meningitis in patients who were diagnosed and treated,60 patients were treated as tuberculous meningitis group A randomly,50 patients were used as tuberculous meningitis group B,in addition,20 patients with another central nervous system infection were collected as control group,Group A were extracted cerebrospinal fluid in order to send cerebrospinal fluid routine,biochemical,tuberculous smear,GeneXpert MTB/RIF,Group B take cerebrospinal fluid routine biochemical,tuberculous smear,tuberculous culture and LAMP,and cerebrospinal fluid routine,biochemical tuberculous smear,tuberculous culture,GeneXpert MTB/RIF and LAMP were taken from control group. Results In the group A,32 patients were positive in cerebrospinal GeneXpert MTB/RIF,the cerebrospinal fluid GeneXpert MTB/RIF lifampin resistance gene was positive in 3 patients,5 patients were positive in cerebrospinal tuberculous smear with positive rate was 8.3%,10 patients were positive in cerebrospinal fluid tuberculous culture,and the posi⁃ tive rate was 16.7%,32 patients were diagnosed with cerebrospinal fluid GeneXpert MTB/RIF lead to 53.0% posi⁃ tive rate,In the group B,the positive rates of cerebrospinal fluid tuberculous smear,tuberculous culture and LAMP were 8.0%,18.0% and 58.0%,respectively. In the control group,patients had negative result in cerebrospi⁃ nal fluid tuberculous smear,tuberculous culture,GeneXpert MTB/RIF and LAMP. Conclusions Cerebrospinal fluid GeneXpert MTB/RIF and LAMP are good methods for early diagnosis of tuberculous meningitis. 

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