结核分枝杆菌四种常用方法检测比较

Comparison of detection of Mycobacterium tuberculosis with four experimental methods

目的分析2014年结核标本检测结果并比较4种实验室常用检测方法以评价其临床应用价值。方法对2014年792份结核标本进行实验室检测,并对罗氏改良培养法、荧光定量PCR法、涂片金胺O染色法及T-SPOT.TB等四种方法结果进行比较。结果 792例标本中共有37例阳性,占4.7%;培养法具有高的灵敏度(100.0%),TB-PCR法特异度可以达到100.0%,金胺O染色灵敏度较低为64.9%,T-SPOT.TB灵敏度为97.3%、但特异度不足90%。结论金胺O染色和结核培养可以应用于基层医院;对于有条件的医院,临床医师应根据患者特征选择适当的检测方法,科学地结合TB-PCR和/或T-SPOT.TB,以提高临床诊断的准确率。

Objective To analyze the results of tuberculosis（TB）detection in 2014 and assess the value of 4 assays indetection of tuberculosis. Methods The results of detection of 792 TB samples in 2014 were analyzed, and the results of 4detection methods, including Roche modified culture method, fluorescent quantitative PCR method, smear auramine O stainingand T-SPOT. TB were compared. Results There were 37 positive cases in 792 samples, with a positive rate of 4.7%. Thesensitive of Roche modified culture method was high（100%）, and the specificity of TB-PCR was also 100%, the sensitivities ofsmear auramine O staining and T-SPOT.TB were 64.9% and 97.3%, respectively,but the specificity of T-SPOT was less than90%. Conclusion Auramine O staing and TB culture can be applied in primary hospitals,and be combined with TB-PCRand/or T- SPOT.TB in some equipment- advanced hospitals according to characteristics of patients,so as to improve theaccuracy of diagnosis.