结核杆菌RNA、结核杆菌DNA及γ-干扰素释放试验联合检测对菌阴性肺结核的诊断价值  

Detection of TB-RNA, TB-DNA combined with interferon gamma release assay in the diagnosis of smear negative Tuberculosis

作　　者：李德新[1] 高江彦[1] 邢艳荣[2] 李振生[3] 

机构地区：[1]河北省胸科医院心内科,石家庄050041 [2]河北省胸科医院ICU,石家庄050041 [3]河北省胸科医院呼吸二科,石家庄050041

出　　处：《国际呼吸杂志》2017年第13期966-969,共4页International Journal of Respiration

摘　　要：目的 探讨结核杆菌 RNA （TB-RNA）,结核杆菌 DNA （TB-DNA）及γ-干扰素释放试验 （IGRA）联合检测对菌阴性肺结核的诊断价值。方法 选择自2011年1月至2015年12月河北省胸科医院住院或门诊期间疑诊为肺结核的212例患者,根据痰涂片或痰培养结果分为初治菌阴性肺结核组 （n=94）和初治菌阳性肺结核组 （n =72）及非结核疾病组 （n =46）,分别行 TB-RNA、 TB-DNA、IGRA 检测,对各检测结果进行对比,并行 TB-RNA、TB-DNA、IGRA 联合检测结果与单用检测对比分析。结果 ①单项检测中 TB-RNA、TB-DNA、IGRA 对初治菌阳对照组的敏感度分别为56.9%,65.3%,81.9%;特异度分别为97.8%,95.8%,97.8%;②单项检测对菌阴肺结核的检出率相应为：50.0%,54.3%,77.7%;③联合检测对菌阴肺结核的检出率为88%,均明显高于单项检测。结论 TB-RNA、TB-DNA、IGRA 联合检测提高了菌阴肺结核的检出率。Objective To analyze the value of smear negative Tuberculosis diagnosis by detecting TB-RNA, TB-DNA combined with interferon gamma release assay （IGRA）. Methods 212 suspected pulmonary Tuberculosis patients were confirmed and divided into 3 groups in Hebei Provence Chest Hospital from January 2011 to December 2015. The group A had 94 cases of smear negative Tuberculosis, the group 13 had 72 cases of smear positive Tuberculosis, and the group C had 46 cases of non-Tuberculosis respiratory. The 3 groups were given TB-RNA, TB-DNA combined with IGRA, and the diagnosis value of single and joint examination for 3 groups were evaluated. Results ①in single examination sensitivity of TB-RNA, TB-DNA and IGRA was 56.9%, 65.3%,81.9% ; respectively specificity was 97.8%, 95.8%, 97.8% ;②The positive detection rate of single examination for smear negative Tuberculosis was 50.0%, 54.30%, 77.70/00; ③The combination examination for smear negative Tuberculosis was 88%. It was obvious higher than single examination. Conclusions It is valuable for widely use of combination method in detection of smear negative Tuberculosis.

关 键 词：肺结核 结核杆菌RNA 结核杆菌DNA Γ-干扰素释放试验 

分 类 号：R521[医药卫生—内科学]