三种结核抗体检查诊断活动性肺结核比较  

Three Kinds of Serum Tuberculosis Antibody Test in Diagnosis of Active Tuberculosis

作　　者：赵文娟[1] 张翠英[1] 高玉然[1] 

机构地区：[1]解放军第309医院全军结核病研究所,北京100091

出　　处：《预防医学情报杂志》2012年第9期702-705,共4页Journal of Preventive Medicine Information

基　　金：军队后勤十二五科研课题重点项目<部队结核感染与发病监测;预警与保障关键技术的研究>

摘　　要：目的比较3种常用结核抗体检测试剂盒的临床价值。方法用SD结核杆菌抗体检测试剂盒、TB-CHECK诊断试剂盒、TB-DOT诊断试剂盒检测232例部队活动性肺结核和50例非结核患者,对比分析敏感性、特异性。痰涂片和培养按常规实验室操作。结果 232例肺结核患者中SD的敏感性为16.38%,特异性为100%;TB-CHECK的敏感性为49.57%,特异性为98%;TB-DOT的敏感性最高为78.45%,特异性为92%。3种检测方法的敏感性差别有统计学意义(P<0.01);3种试剂盒联合检测敏感性可达到86.21%,特异性92%,高于单项试剂盒检测灵敏度(P<0.01)。其中201例肺结核患者同时进行痰菌检查,痰菌阳性率为23.88%。结论 3种检测试剂盒在活动性肺结核中的诊断价值不同,SD试剂盒和痰涂片敏感性较低,3种试剂盒联合检测综合分析可提高结核病诊断和鉴别诊断价值,是敏感、特异、快速、简便和低廉的方法。Objective To estimate the value of three kinds of tuberculous antibodies in diagnosis of active tuberculosis. Methods Selected SD rapid test, TB - CHECK test card, TB - DOT test card to detect tuberculosis anti- bodies of 232 patients with active tuberculosis and 50 healthy individuals （ serum）, with the sensitivity and specificity compared. Sputum smear and its culture were operated according to common laboratory instruction. Results The sensitivity and specificity of SD test were 16. 38%, 100% respectively; of TB - CHECK test card were 49. 57%, 98% respectively; of TB - DOT test were 78.45%, 92% respectively; there was statistical difference （P 〈 0. 01 ） in the sensitivities detected by three kinds. The general sensitivity and specificity of combined the three test was 86.21%, 92%, that was higher than any one single test method statistically （P 〈 0. 01 ）. Positive rate of sputum was 23.88% low. Conclusion The diagnosis values of three kinds of serum tuberculosis antibody in the diagnosis of active tuberculosis were different, SD test and sputum smear test had lower sensitivity. Comprehensive analysis of the combination of three kinds of kit detection can improve TB diagnosis and increase the value of differential diagnosis, it is a sensitive, specific, fast, easy and inexpensive way.

关 键 词：肺结核 诊断 抗体检测 

分 类 号：R521[医药卫生—内科学]