结核分枝杆菌RNA检测在耐药肺结核患者疗效监测中的临床价值研究

doi:10.19871/j.cnki.xfcrbzz.2025.02.005

新发传染病电子杂志 ›› 2025, Vol. 10 ›› Issue (2): 24-28.doi: 10.19871/j.cnki.xfcrbzz.2025.02.005

结核分枝杆菌RNA检测在耐药肺结核患者疗效监测中的临床价值研究

周游¹, 何希², 黄丽花³, 罗兰波³, 胡敏³, 陈桂彬³, 刘爱梅⁴, 黄启文⁵, 杨小兵¹

1.广西壮族自治区胸科医院科教科生物样本库, 广西柳州 545005;
2.广西壮族自治区胸科医院胸心外科, 广西柳州 545005;
3.广西壮族自治区胸科医院医学检验科, 广西柳州 545005;
4.广西壮族自治区胸科医院院长办公室, 广西柳州 545005;
5.广西壮族自治区胸科医院结核科四病区, 广西柳州 545005

收稿日期:2024-11-10 发布日期:2025-06-16
通讯作者: 杨小兵,Email:Yangxb110@sina.com
基金资助:
1.广西医疗卫生适宜技术开发与推广应用项目（S2021031）; 2.广西科技重大专项（桂科AA22096027）

Clinical value of Mycobacterium tuberculosis RNA detection in efficacy monitoring of drug-resistant pulmonary tuberculosis patients

Zhou You¹, He Xi², Huang Lihua³, Luo Lanbo³, Hu Min³, Chen Guibin³, Liu Aimei⁴, Huang Qiwen⁵, Yang Xiaobing¹

1. Department of Biological Sample Bank of Science and Education, Chest Hospital of Guangxi Zhuang Autonomous Region, Guangxi Liuzhou 545005, China;
2. Department of Thoracic and Cardiac Surgery, Chest Hospital of Guangxi Zhuang Autonomous Region, Guangxi Liuzhou 545005, China;
3. Department of Medical Laboratory, Chest Hospital of Guangxi Zhuang Autonomous Region, Guangxi Liuzhou 545005, China;
4. Office of the President of Chest Hospital of Guangxi Zhuang Autonomous Region, Guangxi Liuzhou 545005, China;
5. The Fourth Ward of Tuberculosis Department, Chest Hospital of Guangxi Zhuang Autonomous Region, Guangxi Liuzhou 545005, China

Received:2024-11-10 Published:2025-06-16

摘要/Abstract

摘要： 目的对比结核分枝杆菌核糖核酸（Mycobacterium tuberculosis ribonucleic acid,TB-RNA）检测与传统方法的阳性检出率,探索其在耐药肺结核患者疗效监测中的临床价值。方法选取2022年11月至2024年5月在广西壮族自治区胸科医院结核科住院的耐药肺结核患者,经筛选排除最终得到耐药肺结核患者117例。比较TB-RNA和痰涂片、固体培养在基线及治疗1~6个月期间的阳性检出率;使用Kappa检验评估TB-RNA和痰涂片与固体培养结果的一致性。结果以临床诊断为参考标准,在基线及治疗1~6个月期间,TB-RNA检测痰标本的阳性检出率均高于固体培养和痰涂片,其中在基线及治疗1个月、2个月、4个月、5个月期间,和痰涂片相比,差异有统计学意义（均P<0.05）;在基线及治疗1个月、2个月、4个月期间,和固体培养相比,差异有统计学意义（均P<0.05）。以固体培养及菌种鉴定结果为参考标准,基线及治疗1个月、2个月、4个月期间,TB-RNA敏感度和阴性预测值都高于痰涂片;TB-RNA检测痰标本与固体培养结果的Kappa一致性高于痰涂片与固体培养的一致性。结论 TB-RNA用于耐药肺结核的疗效监测具有良好的检测效能,现阶段虽不能完全替代传统方法,但TB-RNA更适合于耐药肺结核的长时间疗效监测。

关键词: 结核分枝杆菌核糖核酸, 耐药肺结核, 疗效监测, Kappa分析, 临床价值

Abstract: Objective The positive detection rate of Mycobacterium tuberculosis ribonucleic acid (TB-RNA) detection was compared with that of traditional methods, and the clinical value of Mycobacterium tuberculosis ribonucleic acid (TB-RNA) detection in monitoring the efficacy of drug-resistant pulmonary tuberculosis patients was explored. Method A total of 117 patients with drug-resistant pulmonary tuberculosis who were hospitalized in the tuberculosis Department of Guangxi Chest Hospital from November 2022 to May 2024 were selected. The positive detection rates of TB-RNA, smear and solid culture were compared at baseline and from 1 to 6 months after treatment. Kappa test was used to evaluate the consistency of TB-RNA and smear results with solid culture results. Result Using clinical diagnosis as a reference standard, the positive detection rate of sputum specimens for TB-RNA testing was higher than that of solid cultures and smears at baseline and during the treatment period of 1-6 months.Among them, there was a statistically significant difference between the baseline and the treatment period of 1 month, 2 month, 4 month and 5 month (P<0.05). At baseline and during 1, 2 and 4 months of treatment, the difference was statistically significant compared with solid culture (P<0.05).Using the results of solid culture and strain identification as reference standards, the sensitivity and negative predictive value of TB-RNA were higher than that of smear at baseline and during 1, 2 and 4 months of treatment. Kappa concordance between TB-RNA and solid culture results was higher than smear. Conclusion TB-RNA has good efficacy in monitoring the efficacy of drug-resistant pulmonary tuberculosis. At present, although it cannot completely replace traditional methods, TB-RNA is more suitable for long-term efficacy monitoring of drug-resistant pulmonary tuberculosis.

Key words: Mycobacterium tuberculosis ribonucleic acid, Drug-resistant pulmonary tuberculosis, Efficacy detection, Kappa analysis, Clinical value

中图分类号:

R446

周游, 何希, 黄丽花, 罗兰波, 胡敏, 陈桂彬, 刘爱梅, 黄启文, 杨小兵. 结核分枝杆菌RNA检测在耐药肺结核患者疗效监测中的临床价值研究[J]. 新发传染病电子杂志, 2025, 10(2): 24-28.

Zhou You, He Xi, Huang Lihua, Luo Lanbo, Hu Min, Chen Guibin, Liu Aimei, Huang Qiwen, Yang Xiaobing. Clinical value of Mycobacterium tuberculosis RNA detection in efficacy monitoring of drug-resistant pulmonary tuberculosis patients[J]. Electronic Journal of Emerging Infectious Diseases, 2025, 10(2): 24-28.

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结核分枝杆菌RNA检测在耐药肺结核患者疗效监测中的临床价值研究

Clinical value of Mycobacterium tuberculosis RNA detection in efficacy monitoring of drug-resistant pulmonary tuberculosis patients

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