核酸扩增检测结核杆菌DNA方法在肺结核诊断中的临床价值

Nucleic acid amplification method of detecting mycobacterium tuberculosis clinical value in the diagnosis of tuberculosis

目的确定核酸扩增结核杆菌DNA检测与抗酸杆菌涂片镜检两种方法在临床诊断上的应用价值。方法选取2009年11月至2011年5月肺结核病例208例为结核组,同期36例非结核病患者作为非结核组,对两组患者晨起痰液进行核酸扩增荧光定量聚合酶链反应(polyerase chain reaction,PCR)和涂片抗酸杆菌镜检,对痰检结果阳性率进行x2检验。结果 208例结核病患者的痰液中,FQ-PCR法和涂片抗酸染色法检出的阳性率分别为51.92%和25.96%,FQ-PCR法痰检患者结核杆菌DNA的阳性率明显高于涂片法,两种方法相比差异有统计学意义(x2=29.48,p<0.01);对两组方法的特异性及敏感性进行分析,两种方法特异性无统计学差异(x2=2.35,p>0.05),敏感性有统计学差异(x2=9.447,p<0.01)。结论荧光定量PCR检测技术对临床上肺结核病的诊断和鉴别诊断有较高的应用价值。

Objective To determine the value of pulmonary tuberculosis clinical diagnosis, by two methods for examination of patients that Mycobacterium tuberculosis DNA and acid-fast bacilli smear. Methods 208 cases of patients by tuberculosis during 2009. 11 to 2011.5 in hospital were treated as experimental group and 36 cases of non-tuberculosis With the time as a control group. With tuberculosis from sputum morning for nucleic acid amplification by polymerase chain reaction fluorescence quantitative （polymerase reaction, PCR） and acid-fast bacillus examination, their positive To x2 test results and Analysis of two groups method of specificity and sensitivity. Results 208 cases of tuberculosis in sputum smear acid-fast staining, FQ-PCR method and the positive rate of detection was 51.92% and 25.96%, Patients with sputum.positive rate of detection of Mycobacterium tuberculosis FQ-PCR was higher than that of the smear, they are significant differences compared two methods （x2=29,48, p〈0.01）; Specificity of two and sensitivity analysis method, two methods of specificity of no significant difference （x2=2.35, p〉0.05）, there were significant differences in sensitivity （x2=9.447, p〈0.01）. Conclusions The application value of fluorescence quantitative PCR detection technology has high clinical diagnosis and differential diagnosis of pulmonary tuberculosis.