目的：探讨利福平耐药实时荧光定量核酸扩增检测技术(Xpert MTB/RIF)对涂阴肺结核诊断的临床价值。方法选择2014年6~12月株洲市中心医院结核门诊涂阴肺结核病患者131例(涂阴肺结核组)，肺结核确诊患者114例(肺结核确诊组)，其他肺病患者123例(其他肺病组)。对患者进行痰抗酸染色、结核菌素皮肤试验(TST)、痰固体培养和Xpert MTB/RIF检测，分析Xpert MTB/RIF检测的阳性率和特异度，判断其在涂阴肺结核中的诊断价值。结果 Xpert MTB/RIF检测在涂阴肺结核组中阳性率为80.92%(106/131)，在肺结核确诊组中为82.45%(94/114)，在其他肺病组中为0.81%(1/123)，涂阴肺结核组中Xpert MTB/RIF检测阳性率明显高于其他肺病组，差异有高度统计学意义(P<0.01)；涂阴肺结核中痰培养检测阳性率为71.76%(94/131)，明显低于Xpert MTB/RIF检测阳性率，差异有统计学意义(P<0.05)。结论 Xpert MTB/RIF检测阳性率和特异性较高，对涂阴肺结核早期诊断有重要的意义。%Objective To explore the clinical value of Xpert MTB/RIF for testing smear negative plumonary tuberculo-sis (SNPT). Methods From June to December 2014, 368 cases, including 131 SNPT (SNPT group), 114 pulmonary tu-berculosis (pulmonary tuberculosis group) and 123 other kinds of pulmonary disease (other pulmonary disease group) in Tuberculosis Clinic of Zhuzhou Central Hospital were detected of anti-acid stain test, tuberculin skin test (TST), spu-tum culture test and Xpert MTB/RIF. The positive rates and specificity of Xpert MTB/RIF test determining the diagnos-tic value of SNPT were analyzed. Results The positive rate of Xpert MTB/RIF test was 80.92% (106/131) in SNPT group, 82.45%(94/114) in pulmonary tuberculosis group and 0.81%(1/123) in other pulmonary disease group. The posi-tive rate of Xpert MTB/RIF test in SNPT group was obviously higher than that in other pulmonary disease group, and the difference was statistically significance (P < 0.01). The positive rate of sputum culture test in SNPT group was 71.76%(94/131), which was obviously lower than that of Xpert MTB/RIF, and the difference was statistically signifi-cance (P< 0.05). Conclusion The positive rate and specificity of Xpert MTB/RIF test are high, which has important significance on early diagnosis of SNPT.
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