痰标本中结核杆菌分泌蛋白抗原检测在活动性肺结核诊断中的应用价值

Applied value of the Mycobacterium tuberculosis secreted protein antigen detection in sputum for the diagnosis of active tuberculosis

目的了解痰标本中结核杆菌分泌蛋白抗原检测在活动性肺结核诊断中的应用价值。方法选取109例确诊肺结核患者作为实验组,对照组选取住院肺部疾病患者27例和医院职工查体健康者71名。采用痰厚涂片抗酸染色检测、痰结核杆菌分泌蛋白抗原检测、痰结核杆菌Gene Xpert检测进行实验。数据采用SPSS 17.0进行统计分析。结果TBAg快速检测敏感度和特异度分别为50.5%和86.7%,与Gene Xpert MTB/RIF法检测结果基本一致,阳性率分别为50.5%和55.0%。TBAg检测在Gene Xpert MTB/RIF法阳性组的阳性检出率为61.7%,而在Gene Xpert MTB/RIF法阴性组的阳性检出率为32.7%。TBAg阳性55例,平均用药时间为(32.3±11.4)d;TBAg检测阴性54例,平均用药时间为(28.2±9.6)d。结论结核杆菌分泌蛋白抗原快速检测技术直接检测痰标本,操作简便、快速、敏感度和特异度较高,对早期诊断活动性肺结核具有较大价值。

Objective To investigate applied value of Mycobacterium tuberculosis secreted protein antigen detection in sputum for the diagnosis of active tuberculosis. Methods 109 cases of diagnosed tuberculosis patients were chosen as the experimental group and 27 cases of hospitalized patients with lung disease and 71 cases of hospital staff who were healthy after health examina- tion were selected in the control group. Experiments were occupied by sputum smear acid - fast staining thick detection, sputum secreted protein antigen test, and sputum GeneXpert detection. The data was statistically analyzed using SPSS 17.0. Results TBAg rapid detection＇ s sensitivity and specificity were 50.5% and 86.7%, which was consistent with the GeneXpert MTB/RIF test results, and the positive rate was 50.5% and 55.0%, respectively. The positive rate of TBAg detection in GeneXpert MTB/RIF positive group was 61.7%, while the positive rate was 32.7% in the GeneXpert MTB/RIF negative group. TBAg tested 55 positive cases, with an average treatment time was （32.3±11.4） d; while TBAg tested 54 cases nega- tive, with an average treatment time was （28.2 ±9.6） d. Conclusion Mycobacterium tuberculosis secreted protein antigen rap- id test technology can detect sputum specimen directly, and has greater value for the early diagnosis of active tuberculosis with simple and rapid operation, high sensitivity and specificity. It has great value for the early diagnosis of active tuberculosis. Key Words： Sputum; Antigen detection; Diagnosis ; Value