结核抗体检验在肺结核鉴别诊断中的应用价值  

Application Value of TB Antibody Test in Differential Diagnosis of Pulmonary Tuberculosis

作　　者：廖育荣[1] LIAO Yulong(The First Affiliated Hospital of Xiamen University,Xiamen 361000,China)

机构地区：[1]厦门大学附属第一医院,厦门361000

出　　处：《中国医药指南》2024年第2期13-16,共4页Guide of China Medicine

摘　　要：目的探讨结核抗体检验对肺结核的鉴别诊断价值。方法选取130例我院2021年8月至2022年8月就诊的疑似肺结核患者作为研究对象,入院后均行结核抗体检验及结核菌素(PPD)试验,以临床诊断结果为“金标准”,比较不同结核抗体检验方法对肺结核诊断价值,选取诊断准确率最高的结核抗体检验方案,分析其联合PPD试验对肺结核的诊断效能,并比较其对于不同类型肺结核检出率。结果与酶联免疫吸附法、蛋白芯片法比较,胶体金法结核抗体检验对于肺结核诊断灵敏度82.93%、准确度86.92%较高,漏诊率17.07%较低(P<0.05);与胶体金法结核抗体检验、PPD试验单独诊断比较,联合诊断灵敏度96.34%、准确度95.38%较高,漏诊率3.66%较低(P<0.05);与胶体金法结核抗体检验、PPD试验单独诊断比较,联合诊断对于血行播散性肺结核、结核性胸膜炎检出率较高(P<0.05)。结论胶体金法结核抗体检验可用于肺结核早期诊断中,联合PPD试验可进一步提高诊断效能,为临床早期筛查诊断、制订治疗方案提供参考。Objective To explore the value of combined antibody test in differential diagnosis of pulmonary tuberculosis.Methods A total of 130 patients with suspected pulmonary tuberculosis who received medical treatment in our hospital from August 2021 to August 2022 were selected as the study objects.After admission,tuberculosis antibody test and tuberculin(PPD)test were performed.Clinical diagnosis results were taken as the"gold standard"to compare the diagnostic value of different combined antibody test methods for pulmonary tuberculosis.The tuberculosis antibody test with the highest diagnostic accuracy was selected to analyze its diagnostic efficacy in combination with PPD test for tuberculosis,and its detection rate for different types of tuberculosis was compared.Results Compared with enzyme-linked immunosorbent assay and protein microarray assay,the sensitivity and accuracy of colloidal gold assay were higher(82.93%),86.92%,and the missed diagnosis rate was lower(17.07%).Compared with the colloid gold antibody test and PPD test,the sensitivity and accuracy of combined diagnosis were 96.34%and 95.38%higher,and the missed diagnosis rate was 3.66%lower(P<0.05).Compared with the colloid gold TB antibody test and PPD test alone,the combined diagnosis had a higher detection rate for disseminated pulmonary tuberculosis and tuberculous pleurisy(P<0.05).Conclusions Colloidal gold TB antibody test can be used in the early diagnosis of tuberculosis,and the combination of PPD test can further improve the diagnostic efficiency,and provide reference for early clinical screening and treatment.

关 键 词：结核抗体检验 PPD试验 肺结核 鉴别诊断 

分 类 号：R52[医药卫生—内科学]