检测结核杆菌六种实验方法的比较分析

COMPARTIVE ANALYSIS OF SIX METHODS FOR DETECTING BACILLUS TUBERCULOSIS

应用聚合酶链反应（ＰＣＲ）、涂片抗酸染色，ＢＡＣＴＥＣ快速培养、Ｌ－Ｊ法培养、ＥＬＩＳＡ测ＰＰＤ－ＩｇＧ和结核杆菌抗原六种方法对５７例临床肺部病人和３６例中枢神经系统（ＣＮＳ）感染病人检测结核杆菌。结果表明：对肺部病人还是ＣＮＳ感染病人，ＰＣＲ检测结核杆菌的阳性率最高，ＰＣＲ对肺结核病人的敏感性和特异性分别为９６．７％和１００％，对结核性脑膜炎病人的敏感性和特异性均为１００％；六种方法中敏感性最低的是涂片法，肺结核为３３％，结核性脑膜炎为２０％；ＢＡＣＴＥＣ快速培养法敏感性（痰７６．７％，ＣＳＦ５０％）高于Ｌ－Ｊ法（痰６０％，ＣＳＦ２５％）；免疫学方法敏感性较高，但存在一定假阳性。实验结果表明ＰＣＲ技术是早期、快速印准确地诊断结核病的有效方法。

This paper reports the detection of tuberculous bacilli from sputa of 57cases of lung diseases and CSF of 36 cases of CNS diseeses using six methods, such as PCR,acid-fast stained smear, BACTEC rapid culture,L-J culture, ELISA for PPD-IgG in sera and ELISA for B. Tuberculosis antigen in CSF, The results showed that the positive detection rate of B. Tuberculosis by PCR was the hithest among methods used, and the sensitity and specificity of PCR for pulmonary tuberculosis were 96.7% and 100%, and that for tuberculous meningitis being 100% for each;the sensitivity of acid-fasst stained smear method was the lowest, being 33% for pulmonary tuberculosis.and 20% for tuberculous meningitis; the sensitivity of BACTEC rapid culture (76% for sputum and 50% for CSF) was higher than that of L-J method (60% for sputum and 25% for CSF);Immunoassay has higher sensitivity but often show certain false positive results. Through experimental study it is evident that PCR technique is a rapid , accurate method for detecting tuberculous bacilli and an efficient method for early diagnosis of the disease.