菌阴肺结核诊断采用多指标联合检测同时阳性的临床意义

Clinical significance of positive results of diagnosing negative pulmonary tuberculosis by multi-index united detection

目的:探讨分析菌阴肺结核诊断采用多指标联合检测同时阳性的临床意义。方法:本文研究对象选自我院2014年10月-2015年10月收治的120例菌阴肺结核患者,根据检测指标将其分为初治菌阳对照组,非结核肺疾病组和初治菌阴组,每组40例,采用血清抗结核抗体(TB-Ab)、痰聚合酶链反应(PCR)、结核菌素纯蛋白衍生物(PPD)、血沉(ESR)四个检测指标,分别运用单项检测和联合检测方式,观察单项检测指标敏感性、特异性和联合检测对非结核肺疾病组、初治菌阳对照组的共同阳性检测率。结果:4项检测指标的敏感性不同,其中PCR要明显高于ESR、TB-Ab及PPD,组间对比差异有统计学意义(P<0.05)。但ESR、TB-Ab及PPD等指标的敏感性对比差异无统计学意义(P>0.05)。4项检测指标的特异性达90%以上。2种、3种、4种联合检测特异性均高达97%,其中初治菌阳对照组的不同指标联合检测同时阳性检出率和非结核肺疾病组相比,差异有统计学意义(P<0.05)。结论:多指标联合检测能提高菌阴肺结核诊断的特异性和敏感性,比单项检测阳性率高,可有效减少菌阴肺结核的误诊和漏诊,值得临床推广和应用。

Objective： Clinical significance of positive results of diagnosing negative pulmonary tuberculosis by multi-index united detection was investigated. Methods： 120 cases were divided into the positive bacteria group, the non-tuberculosis group and the negative bacteria group according to detection indexes, 40 cases in each. Detection indexes included TB-Ab, PCR, PPD and ESR. Single detection and united detection were applied. Results： The sensitivity of the 4 indexes was different; PCR was significantly higher than others, with a statistically significant difference. Sensitivity of ESR, TB-Ab and PPD showed no statistically significant difference. The specificity of the 4 test indicators was more than 90%. The united specificity of 2-kind, 3-kind and 4-king were all about 97%. The difference of positive detection rate by different indicators united detection between the positive bacteria group and the non-tuberculosis group was statistical significant. Conclusion： Multi-index united detection could improve specificity and sensitivity of diagnosis for negative pulmonary tuberculosis; positive rate was higher than single detection, could effectively reduce the misdiagnosis and misdiagnosis of negative pulmonary tuberculosis, and is worthy of clinical application and promotion.