5种方法联合检测力阴肺结核诊断价值的研究

目的 探讨痰聚合酶链反应（ＰＣＲ）ＴＢ－ＤＮＡ检测、血清结核分支杆菌糖脂免疫球蛋白Ｇ（ＬＡＭＩｇＧ）、卡介菌免疫球蛋白Ｇ（ＰＰＤＩｇＧ）、结核特异性循环免疫复合物（ＳＣＩＣ）与结核菌素（ＰＰＤ）０．１Ｕ皮试联合检测对菌阴肺结核的诊断价值。方法 以上述５种检测方法用于力阳肺结核３１例、健康对照５３例、非结核肺疾病３０例、初治菌阴肺结核５４例同步检测。血清免疫学检测用酶联免疫吸附试验（ＥＬＩＳＡ）。对

Studies on 5 kinds of methods combination for detection of smear and culture negative pulmonary tuberculosis

OBJECTIVE: To evaluate the diagnostic value of 5 kinds of methods used jointly for smear and culture negative pulmonary tuberculosis. METHODS: The high specificity methods were PCR examination for sputum TB-DNA, immunological examination (ELISA method) for serum LAM IgG, PPD IgG, SCIC and PPD 0.1 U skin test. Smear and culture positive cases were 31, smear and culture negative 54, healthy control 53, other lung disease 30. Methods were used for every case synchronously, then the sensitivity and specificity of single method and the diagnostic value of single and joint examination for smear and culture negative patients were evaluated. RESULTS: In single examination sensitivity of PCR, LAM IgG, PPD IgG, SCIC, PPD 0.1 U was 96.8%, 69.2%, 62.1%, 32.0%, 53.8% respectively; specificity was 96.2%, 98.1%, 98.1%, 98.1% correspondingly. The positive detection rate of single examination for sputum TB negative patients was just 21.4%-44.4%. In combination examination the positive rates increased remarkblely by the number combined from 2 to 5, they were 66.9%, 70.5%, 80.4%, 85.7% respectively and they were more notable than that of TB positive group. The specificity of combination examination was slightly decreased by the number combined. It decreased just by 9% and the specificity of most examination methods kept on no less than 90%. CONCLUSIONS: For diagnosis of smear and culture negative pulmonary tuberculosis combination examination using the high specificity methods can increase the sensitivity obviously and the specificity just decrease slightly. It is valuable for widely use of combination method in detection of smear and culture negative patients.