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中国防痨杂志 ›› 2024, Vol. 46 ›› Issue (2): 173-177.doi: 10.19982/j.issn.1000-6621.20230321

• 论著 • 上一篇    下一篇

GeneXpert MTB/RIF检测技术在新疆结核病防治规划中的应用效果

古丽娜·巴德尔汗1, 刘年强1, 伊帕尔·艾海提1, 王乐1, 王森路1, 祖力卡提阿衣·阿布都拉1, 王明哲1, 张静1, 王新旗1, 毕洪波2()   

  1. 1新疆维吾尔自治区疾病预防控制中心结核病/麻风病防治中心, 乌鲁木齐 830001
    2新疆维吾尔自治区卫生健康委员会疾病预防控制处, 乌鲁木齐 830001
  • 收稿日期:2023-09-04 出版日期:2024-02-10 发布日期:2024-01-30
  • 通信作者: 毕洪波 E-mail:2306303992@qq.com
  • 基金资助:
    新疆维吾尔自治区卫生健康委青年医学科技人才专项科研项目(WJWY-202239);新疆维吾尔自治区卫生健康委青年医学科技人才专项科研项目(WJWY-202242);新疆维吾尔自治区科学技术协会青年人才托举工程项目(RCTJ42)

The effect of GeneXpert MTB/RIF detection technology in tuberculosis prevention and control program in Xinjiang

Gulina Badeerhan1, Liu Nianqiang1, Yipaer Aihaiti1, Wang Le1, Wang Senlu1, Zulikatiayi Abudula1, Wang Mingzhe1, Zhang Jing1, Wang Xinqi1, Bi Hongbo2()   

  1. 1Tuberculosis/Leprosy Control Center, Xinjiang Uygur Autonomous Region Center for Disease Control and Prevention, Urumqi 830001, China
    2Disease Control Department of the Health Commission of Xinjiang Uygur Autonomous Region, Urumqi 830001, China
  • Received:2023-09-04 Online:2024-02-10 Published:2024-01-30
  • Contact: Bi Hongbo E-mail:2306303992@qq.com
  • Supported by:
    Special Research Project for Young Medical Science and Technology Talents of the Health Commission of Xinjiang Uygur Autonomous Region(WJWY-202239);Special Research Project for Young Medical Science and Technology Talents of the Health Commission of Xinjiang Uygur Autonomous Region(WJWY-202242);Youth Talent Support Project of Xinjiang Uygur Autonomous Region Science and Technology Association(RCTJ42)

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摘要： 目的: 探索在施行结核病防治“新疆模式”中,全面应用 GeneXpert MTB/RIF(简称“GeneXpert”)检测发现肺结核及利福平耐药肺结核的效果。方法: 从“中国疾病预防控制信息系统”的子系统“结核病管理信息系统”中,收集2017—2020年新疆维吾尔自治区(简称“新疆”)肺结核登记数据,对全面应用GeneXpert检测的效果进行分析,评价2017—2020年肺结核病原学阳性率、利福平耐药检测率、利福平耐药患者发现水平的变化。结果: GeneXpert设备覆盖率、GeneXpert检测率、病原学阳性率分别从2017年的20.00%(22/110)、0.32%(126/39261)和20.17%(7919/39261)提高到2020年的100.00%(110/110)、75.16%(19610/26090)和57.94%(15116/26090),差异均有统计学意义(χ2=40.705,P<0.001;χ2=174.087,P<0.001;χ2=47.569,P<0.001)。病原学阳性患者数从2017年的7919例提高到2020年的15116例,仅GeneXpert检测阳性患者数从2017年的6例提高到2020年的7194例,所占比例从0.08%(6/7919)提高到47.59%(7194/15116),差异有统计学意义(χ2=83.824,P<0.001)。病原学阳性肺结核患者利福平耐药筛查率和GeneXpert耐药检测率分别从2017年的44.49%(3523/7919)和1.85%(65/3523)提高到2020年的99.79%(15084/15116)和96.13%(14501/15084),差异均有统计学意义(χ2=133.333,P<0.001;χ2=250.893,P<0.001)。结论: GeneXpert检测技术的应用,可以明显提升病原学阳性和利福平耐药肺结核的发现水平,有利于新疆结核病疫情的快速下降。

关键词: 结核, 肺, 利福平, 抗药性, 核酸扩增技术, 对比研究

Abstract: Objective: To explore the effect of using GeneXpert MTB/RIF (“GeneXpert” for short) to detect pulmonary tuberculosis and rifampicin resistant pulmonary tuberculosis in the implementation of the “Xinjiang model” of tuberculosis prevention and treatment. Methods: The registration data of pulmonary tuberculosis in Xinjiang Uygur Autonomous Region (“Xinjiang” for short) from 2017 to 2020 were collected from the “Tuberculosis Management Information System”, a subsystem of the “China Disease Prevention and Control Information System”, and the effect of the comprehensive application of GeneXpert detection was analyzed. The etiologically positive rate, rifampicin resistance detection rate, rifampicin resistance cases detected from 2017 to 2020 were evaluated. Results: The coverage rate, detection rate of GeneXpert devices, and overall etiologically positivity rate of all patients increased from 20.00% (22/110), 0.32% (126/39261), and 20.17% (7919/39261) in 2017 to 100.00% (110/110), 75.16% (19610/26090), and 57.94% (15116/26090) in 2020, respectively, and the differences were statistically significant (χ2=40.705, P<0.001; χ2=174.087, P<0.001; χ2=47.569, P<0.001). The number of etiologically positive patients increased from 7919 in 2017 to 15116 in 2020, and the number of GeneXpert positive patients alone increased from 6 in 2017 to 7194 in 2020, accounting for an proportion from 0.08% (6/7919) to 47.59% (7194/15116), with a statistically significant difference (χ2=83.824, P<0.001). The screening rate of rifampicin resistance and the resistance screening rate with GeneXpert in etiologically positive pulmonary tuberculosis patients increased from 44.49% (3523/7919) and 1.85% (65/3523) in 2017 to 99.79% (15084/15116) and 96.13% (14501/15084) in 2020, respectively, and the differences were statistically significant (χ2=133.333, P<0.001; χ2=250.893, P<0.001). Conclusion: The application of GeneXpert detection technology can significantly improve the detection level of etiologically positive and rifampicin resistant pulmonary tuberculosis cases, help the rapid decline of local tuberculosis epidemic in Xinjiang.

Key words: Tuberculosis, pulmonary, Rifampin, Drug resistance, Nucleic acid amplification techniques, Comparative study

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