五种方法联合检测同时阳性对菌阴肺结核诊断价值的研究  

Study on diagnostic value of common positive of 5 kinds of methods combination for detection of smear and culture negative pulmonary tuberculosis

作　　者：叶德普[1] 王国斌[1] 彭义利[1] 焦宪法[2] 

机构地区：[1]河南省胸科医院,河南郑州450003 [2]郑州市第五人民医院,河南郑州450003

出　　处：《河南医学研究》2000年第4期315-317,共3页Henan Medical Research

摘　　要：目的：探讨痰聚合酶链反应（ＰＣＲ）ＴＢ－ＤＮＡ、血清中结核分支杆菌胞壁糖脂免疫球蛋白 Ｃ（ＬＡＭＩｇＧ）、卡介苗 免疫球蛋白 Ｇ（ＰＰＤ ＩｇＧ）及结核特异循环免疫复合物（ＳＣＩＣ）检测与结核菌素（ＰＰＤ ０．１ｕ）皮试，联合检测共同阳性 对菌阴肺结核的诊断价值。方法：病材取自初治菌阴肺结核３１例，健康对照组５３例，非结核肺疾病３０例，初治 菌阴肺结核５４例。采用同步检测方法。血清免疫学检测用酶联免疫吸附试验（ＥＬＩＳＡ）观察各组共同阳性率的变 化，对结果进行分析评价。结果：健康对照组２、３、４、５联阳性率均为０，特异性为１００％；初治菌阳组２、３、４、５联同 时阳性率分别为６７．７％，５８．１％，３２．３％，０％；初治菌阴组２、３、４．５联共同阳性率分别为４５．９％，１８．９％，２．７％， ０％；非结核肺疾病组２、３、４、５联合同时阳性率分别为２１．７％，１３．０％，０％，０％。结论：五种方法联合对健康组２、 ３、４、５联同时阳性检测特异性可达１００％，初治菌阴组阳性检出率２联可达４５．９％，比任何单项方法检出率要高， 由于原五种方法联合检测特异性有所下降，因此该方法更适用于初治菌阴肺结核的诊断，值得推广。Objective: To evaluate the diagnostic value of common positive of 5 kinds of methods(sputum PCR TB-DNA, serum LAM IgG, PPD IgG, SCIC and PPD 0.1U skin test)used jointly for smear and culture negative pulmonary tuberculosis. Methods: smear and culture positive cases 31, healthy control cases 53, non-tuberculosis lung disease cases 30, smear and culture negative cases 54. Methods were used for every case synchronousely The sputum were detection with PCR-TB-DNA, serum with ELISA and PPD with skin test. Results: The positive rate(2, 3,4,5 methods common positive) is 0, specificity is 100% in the health control group; the common positive rates among 2, 3,4,5 methods respectively are 67. 2%, 58. 1 %, 32. 3%,0% in smear and culture positive group; 45. 9%, 18. 9%, 2. 7%, 0% in smear and culture negative group and 21.7%, 13.0%, 0%,0% in the non-tuberculosis pulmonary diseases group. Conclusion: The specificity of common positive rate of combination detection of 5 kinds of methods is 100% in healthy control group; in smear and culture negative group the positive rate of any 2 combination detections among 5 methods is 45 .9%,higher than any single detection of 5 methods. So those methods are available to smear and culture negative tuberculous diagnosis.

关 键 词：肺结核 诊断 结核菌素试验 PCR 诊断 

分 类 号：R521.04[医药卫生—内科学]