比较四种方法对结核诊断的应用价值  

Comparison of Application Value of Four Methods in Diagnosis of Tuberculosis

作　　者：周世亮[1] 周旭[1] 蒋建勇[1] 

机构地区：[1]湖南省怀化市第一人民医院检验科,湖南怀化418000

出　　处：《实用预防医学》2009年第2期573-574,共2页Practical Preventive Medicine

摘　　要：目的比较浓集菌涂片抗酸染色法(涂片法)、实时荧光定量聚合酶链反应(FQ-PCR)法、结核培养(L-J培养)和血清学方法检测血清结核抗体(TB-Ab)对临床结核诊断的应用价值。方法用涂片法,FQ-PCR法和L-J培养,对200份疑似结核病人呼吸道标本进行检测,同时检测其TB-Ab。结果200份标本,总阳性率涂片法为20.5%,FQ-PCR法为32.5%,培养法为25.0%,血清结核抗体为42.5%;四种方法的灵敏度、特异度分别为:涂片法36.8%和94.3%,FQ-PCR法64.2%和96.2%,培养敏感度为50.5%,特异度为98.1%,血清结核抗体63.2%和76.2%。结论结核培养作为结核诊断的金标准仍是不可缺少的方法,但周期长;FQ-PCR法快速特异性高,有较好诊断价值;血清学方法检测血清结核抗体方便,简单;涂片法直观、简便、价廉,仍将是结核病实验诊断的重要手段,同时检测可从不同方面满足临床需要。Objective To compare the application value of concentration bacteria smear method, real time fluorescence quantitative polymerase chain reaction （FQ PCR） method, Mycobacterium tuberculosis culture, and serological method in detection of serum TB antibodies in clinical diagnosis of tuberculosis （TB）. Methods Respiratory specimens selected from 200 patients suspected tuberculosis were detected by concentration bacteria smear method, FQ- PCR method, and Mycobacterium tuberculosis culture, and TB - Ab was simultaneously detected. Results Totally 200 specimens were submitted, with a total positive rate of 20..5 % in concentration bacteria smear method, 32.5 % in FQ- PCR, 25.0 % in Mycobacterium tuberculosis culture, and 42.5 % in culture- TB serum antibodies. The sensitivities and specificities of concentration bacteria smear method, real time fluorescence quantitative polymerase chain reaction （FQ- PCR） method, Mycobacterium tuberculosis culture, serological method were as follows： 36.8% and 94.3%, 64.2% and 96.2%, 50.5% and 98. 1%, 63.2 % and 76.2 %. Conclusions TB culture as the gold standard for diagnosis of tuberculosis is still indispensable, but the cycle is too long; FQ- PCR method has a better diagnostic value and with high specificity. Serological method is convenient and easy. And concentrated bacteria smear method is intuitive, simple, and inexpensive. Laboratory diagnosis of TB will continue to be an important means of detection, and simultaneous determination can meet the clinical needs in different aspects.

关 键 词：结核杆菌 涂片法 FQ- PCR 培养 TB- Ab 

分 类 号：R52[医药卫生—内科学]