三种结核病实验室检测方法对结核病的临床诊断价值的评价

目的 为评价聚合酶链反应（PCR）、快速培养法（Bactec-460）及酶联免疫吸附试验（ELISA）对结核病的诊断价值。方法 选取123例确诊的结核病患者和41例非结核病患者为研究对象，用PCR、Bactec-460培养法及ELISA三种方法检测，将检测结果用判别分析法和受试者工作特征（ROC）曲线分析法进行分析，以上述三种检测方法为指标，观察进入判别模型的情况进行真实性评价；通过受试者工作特征曲线（ROC）下面积的大小，来比较三个指标对结核病的判别能力。结果 PCR，Bactec-460和ELISA均进入了判别模型，即均有诊断价值；应用ROC曲线分析法时，各指标在曲线下的面积分别为0.9997，0.9998和0.9516。结论 PCR，Bactec-460快速培养法和ELISA诊断结核病均有较高的可靠性；PCR判别能力最强，即为最有价值的指标，而ELISA检测结果对结核病的判别效果相对较弱。

EVALUATION OF ACCURACY OF CLINIC DIAGNOSIS TUBERCULOSIS BY PCR,BACTEC-460 AND ELISA

Aim To evaluate the diagnostic value of PCR,Bactec-460 and ELISA in identifying pulmonary tuberculosis.Methods 123 case with pulmonary Tuberculosis and 41 healthy people were observed and detected by PCR,Bactec-460 and ELISA.The detected results then were analyzed by discrimination and receiver operating characteristic(ROC)cure.These 3 methods were used as the indexes,the order of each method entering as well as the amount of indexes in the discrimination model were evaluated to observe the authority of indexes.By comparing area under ROC,the discrimination ability for 3 methods was also analyzed.Results The discrimination analysis showed that PCR,Bactec-460 and ELISA were all entered into discriminated model(P<0.01),i e.,3 methods have the diagnosis value.Using ROC curve analysis,the areas under curve of each indexes were 0.9997,0.9988 and 0 9516 respectively.Conclusion PCR,Bactec-460 and ELISA were all valuable detecting index for diagnosis of pulmonary tuberculosis.The PCR was the most valuable index among all above indexes,and ELISA had less diagnosis value.