目的 探讨Xpert MTB/RIF与BACTEC MGIT960在检测结核分枝杆菌(MTB)及利福平(RFP)耐药性出现差异的原因.方法 选择2014年6月～2017年6月在南通市第六医人民院就诊的188例复治肺结核患者的涂阳痰标本作为研究对象,分别采用Xpert MTB/RIF及BACTEC MGIT960检测MTB及RFP耐药性并结合患者用药史对结果进行分析.结果 两种方法检测出一致性结果146例,差异性结果38例.使用过含利福霉素类药物且用药时间＞3个月病例组,Xpert MTB/RIF检测出的RFP耐药性病例数高于BACTEC MGIT960,差异有统计学意义(x2=6.31,P＜0.05),其余各组比较,差异无统计学意义(P＞0.05).结论 Xpert MTB/RIF与BACTEC MGIT960检测涂阳痰标本MTB及RFP耐药性会出现部分差异性结果,可能与患者的用药史有关,临床医师应重视两种检查方法的差异性并准确制订抗结核治疗方案.%Objective To explore the differences between Xpert MTB/RIF and BACTEC MGIT960 in detecting Mycobacterium tuberculosis (MTB) and Rifampin (RFP) resistance.Methods From June 2014 to June 2017,sputum specimens from 188 retreated smear positive pulmonary tuberculosis patients in the Sixth People's Hospital of Nantong were selected as research objects.Xpert MTB/RIF and BACTEC MGIT960 were used to detect MTB in the sputum specimens of the patients and the RFP resistance was analyzed combined with the medical history.Results Then were 146 cases of consistency results between Xpert MTB/RIF and BACTEC MGIT960 in detecting MTB,while 38 cases of heterogeneity.The number of cases in Xpert MTB/RIF group was higher than that of BACTEC MGIT960 group in the use of the drug with rifamycin and the duration above 3 months,with statistically significant difference (x2=6.31,P ＜ 0.05).There were no statistically significant differences between Xpert MTB/RIF and BACTEC MGIT960 in the comparison of other medical history groups (P ＞ 0.05).Conlusion The results of Xpert MTB/RIF and BACTEC MGIT960 in detecting MTB and RFP resistance from sputum specimens of smear positive are differential.It may be associated with medical history of the patients.Clinical physicians should pay attention to the differences of the two detection methods and formulate anti-tuberculosis treatment plan accurately.
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