4种方法联合检测在菌阴肺结核临床诊断价值的研究  

Study on 4 kinds of methods combination for detecti on of primary smear and culture negative pulmonary tuberculosis

作　　者：姜秀峰[1] 王嘉祺[1] 董惠芳[1] 蔡曦光[1] 

机构地区：[1]甘肃省人民医院呼吸科,兰州730000

出　　处：《中国防痨杂志》2004年第2期84-88,共5页Chinese Journal of Antituberculosis

摘　　要：目的　探讨痰聚合酶链反应———微孔板杂交技术 (PCR ELISA)、抗脂阿拉伯甘露糖(LAM IgG)抗体、结核菌素 (PPD) 1TU皮试以及血清可溶性白细胞介素 2受体 (sIL 2R)水平 ,4种方法联合检测对初治菌阴肺结核患者临床诊断的意义。方法　以上述 4种方法检测初治菌阳肺结核57例 ,初治菌阴肺结核 58例 ,非结核肺疾病 41例 ,健康对照 36例。分别进行单项与联合检测 ,观察初治菌阴肺结核的特异性与敏感性。结果　PCR ELISA、LAM IgG、TB PPD及sIL 2R单项检测对菌阴肺结核的阳性检出率依次分别为 43 .1 % ,37.9% ,31 .0 % ,50 .0 %。联合检测对菌阴肺结核的阳性检出率 2联、3联及 4联依次分别为 56 .9% ,70 .7% ,84.5 % ,与单项检测的最高阳性检出率相比由50 .0 %提高到 84.5 % ;联合检测的特异性分别为 92 .2 % ,88.3 %和 84.4%。结论　通过 4种方法联合检测能显著提高菌阴肺结核的阳性检出率 ,同时也保持了相对高的特异性。联合检测对于菌阴肺结核的诊断 。Objective To evaluate the diagnostic value of 4 ki nds of methods combination used for primary smear and culture negative pulmonary tuberculosis.Methods The 4 testing methods were PCR ELISA exa mination for sputum;TB DNA, MycoDot method for serum LAM IgG,sandwich ELISA me thod for serum;sIL 2R and PPD 1TU skin test.4 testing methods were used individ ually and in combination manner respectively to 57 smear and culture positive cases,58 smear and culture negative cases,41 non tuberculosis respiratory patien ts and 36 healthy people in control group.Results The positive detection rate of single test by PCR ELIS A,LAM IgG,PPD and sIL 2R for sputum TB negative patients was 43.1% ,37.9%,31.0%,50.0% respectively. In combination examination the positive rate s increased remarkblely by the number combined from 2 to 4, they were 56.9%,70. 7%,84.5% respectively,and the specificity was 92.2% ,88.3%,88.4% ,remain a hi gher speci ficity.Conclusion Using the 4 kinds of methods to diagnose prim ary smear and culture negative pulmonary tuberculosis patients can increase the positive rates of detection obviously and remain a higher specificity. It is val uable for widely use of combination method in detection of primary smear and cul ture negative tuberculosis patients.

关 键 词：联合检测 肺结核 诊断 聚合酶链反应 微孔板杂交 结核菌素 可溶性白细胞介素2受体 

分 类 号：R521[医药卫生—内科学]