结核蛋白芯片联合PPD检测对痰菌阴性肺结核的诊断价值

The diagnostic value of Combined detection of tuberculosis protein chip and PPD in smear and culture negative pulmonary tuberculosis

目的观察结核蛋白芯片和结核菌素纯蛋白衍生物(purifiedproteiderivative,PPD)实验对痰结核分枝杆菌阴性肺结核(菌阴肺结核)的诊断价值。方法采用结核蛋白芯片和PPD实验,检测53例痰菌阴性活动性肺结核和40例非结核性肺部疾病患者,观察两种方法检测的灵敏性、特异性、检测的一致性和联合检测阳性率。结果结核蛋白芯片诊断痰菌阴性肺结核的敏感性和特异性分别为62.3%、87.5%,敏感性明显高于PPD试验(41.5%),特异性无明显差异;两种方法检测一致率为69.8%;两种检测方法联用阳性检出率为88.7%,高于单独应用任一方法。结论结核蛋白芯片检测对痰菌阴性活动性肺结核病人具有较好的诊断价值,联用PPD检测可提高痰菌阴性肺结核患者检出率。

Objective To evaluate the diagnostic value of tuberculosis protein chip and PPD skin test in smear and culture negative pulmonary tuberculosis. Methods The two testing methods were used individually and in combination manner respectively to 53 smear and culture negative cases, 40 non-tuberculosis respiratory patients in control group. Results The sensitivity of tuberculosis protein chip was 62.3%, the specificity was 87.5%. The sensitivity is higher than that of PPD.There is significant differences between two methods. In combination examination the positive rates was increased by 88.7%. Conclusion Tuberculosis protein chip is a better method for pulmonary tuberculosis,and will be valuable in clinical applications. Using the two kinds of methods to diagnose smear and culture negative pulmonary tuberculosis patients can increase the positive rates of detection .