菌阴肺结核诊断方法研究  

The studies on diagnostic methods for detection of smear and culture negative pulmonary tuberculosis

作　　者：叶德普[1] 王国斌[1] 彭义利[1] 

机构地区：[1]河南省结核病防治研究所,河南郑州450003

出　　处：《河南医学研究》2001年第4期331-334,共4页Henan Medical Research

基　　金：河南省医药卫生科技重点项目

摘　　要：目的 :利用联合检测技术对菌阴肺结核作诊断价值的研究。方法 :痰标本采用聚合酶链反应 (PCR)TB DNA ,血清标本采用酶联免疫吸附试验 (ELISA) ,皮肤试验采用PPD 0 1U皮试 ,同步检测。结果 :单项检测的敏感性、特异性依次为 :PCR 96 8%、96 2 % ;LAMIgG 6 9 2 %、98 1% ;PPDIgG 6 2 1%、98 1% ;SCIC 32 2 %、98 1% ;PPD 0 1U 5 3 8%、98 1%。单项检测对菌阴肺结核的检出率相应为 41 7% ,2 8 9% ,44 4% ,2 8 9% ,2 1 4%。联合检测对菌阴肺结核的检出率 2、3、4、5联分别为 6 6 9%、75 0 %、80 4%及 85 7% ,均高于单项检测。联合检测特异性随联合种类增高而轻微下降。若采用联合检测同时阳性方法 ,2、3、4、5联特异性均为 10 0 % ,初治菌阴组阳性检出率 2联方法可达 45 9% ,比任何单项方法检出率要高。结论 :由于原五种方法联合检测特异性有所轻度下降 ,因此联合检测同时阳性判定的方法更适用于初治菌阴肺结核的诊断 。Objective: The studies on diagnostic value for detection of smear and culture negative pulmonary tuberculosis with combination methods.Methods: The high specificity methods were PCR examination for sputums TB DNA,The immunological examination(ELISA)for sera and PPD 0.1 U with skin test.Methods were used for every case synchronously.Results: In single examination sensitivity of PCR?LAM IgG?PPD IgG?SCIC?PPD 0 1 U was 98.6%?69 2%?62 1%?32 0%?53 8%?respectively;specificity was 96 2%?98 1%?98 1%?98 1%?98 1% correspondingly.The postive detection rate of single examination for sputum TB negative patients was just 21 4%～44 4% In combination examination The positive rate increased remarkblely by the number combined from 2 to 5 for the smear and culture negative pulmonary tuberculosis were 66.9%?75 0%?80 4% and 85.7% respectively.The were more notable than that single examination.The speeificity of combined examination was slightly decreaced by the number combined.The positive rate(2,3,4,5 methods common positive)is o,specificity is 100% in the health control groups,the positive rates of smear and culture negative pulmonary tuberculosis is 45.9% for 2 combination methods.Conclusion: Because the specificty is slightly decreased for the 5 kinds of methods combination,the common positive methods are valuable for widely use to detection of smear and culture negative pulmonary tuberculosis.

关 键 词：肺结核 诊断 聚合酶联反应 酶联免疫吸附试验 结核菌素试验 

分 类 号：R521[医药卫生—内科学]