4种不同结核分枝杆菌检测方法对结核病的诊断价值比较

Diagnosis of Mycobacterium tuberculosis:A Clinical Evaluation of Four Detection Methods

目的利用基因芯片法、金标法检测结核抗体、抗酸染色涂片法及结核菌素试验等方法进行结核分枝杆菌的检测诊断比较,以评价不同方法在结核病诊断中的临床应用价值。方法用基因芯片法、金标法检测结核抗体、抗酸染色涂片法及结核菌素试验对172例临床病例或临床标本进行同步检测;比较各方法的检出率、灵敏度及特异度的指标。结果基因芯片法、金标法、抗酸染色法及结核菌素试验检测结核分枝杆菌的阳性率分别为36.0%、50.6%、11.6%和75.6%;4种方法的灵敏度分别为81.6%、73.7%、26.3%和88.2%;特异度分别为100.0%、67.7%、100.0%和34.4%。结论基因芯片法与金标法、抗酸染色法及结核菌素试验比较,具有简便、快速、敏感性高和特异性强等优点,是临床结核病快速诊断的有效检测方法。

OBJECTIVE To compare the gene chip technology （GCT） with the dot immunogold chromatographic assay（DfCA）, the acid-fast stain smear method and the purified protein derivative tuberculin skin testing （PPD） for detection of Mycobacterium tuberculosis in order to evaluate the clinical application value of different methods. METHODS Seventy-six tuberculosis cases, and 96 nontuberculosis cases were detected by the four methods. RESULTS The positive rate of the gene chip, DICA, AFS and PPD were 36.0%, 54.0%, 50.6%, 11.6% and 75.6%, respectively. The sensitivity of the four methods were 81.6%, 73.7%, Z6.3% and 88.2%, while the specificity of the four methods were 100. 0%, 67.7%, 100. 0% and 34. 4%, respectively. CONCLUSIONS Compared with DICA, AFS and PPD, the TB gene chip is simple, rapid, sensitive and specific for detecting tuberculosis, which can be taken as a helpful method for early and rapid detection of M. tuberculosis.