三种方法联合检测对菌阴肺结核的诊断价值

目的：探讨血清抗结核抗体(LAM)、痰聚合酶链反应(PCR)、结核菌素的纯蛋白衍生物(PPD)5IU皮内注射试验三种方法联合检测对菌阴肺结核的诊断价值。方法：以PCR，LAM，PPD 5IU皮试三种方法对42例初治菌阴肺结核患、46例初治菌阳性肺结核患及36例健康人进行检测。结果：单项检测敏感性与特异性依次为LAM67．4％，94．4％；PCR95．7％，97．2％；PPD56．5％，97．2％。单项检测对菌阴性肺结核的检出率分别为PCR47．6％。LAM31．0％，PPD21．4％。联合检测对菌阴性肺结核的检出率明显高于单项检测，联合检测特异性大于90％。结论：三种方法联用对菌阴肺结核的检出率明显增加，特异性好，值得推广。

The Diagnostic Value of Associated Detection of Anti-Tuberculosis Antibody,DNA and Tuberculin Test in Pulmonary Tuberculosis with Negative Spuntumcultivations

Objective:To study the diagnostic value of combined serum anti tuberculosis antibody(LAM),PCR and PPD 5 IU intradermal injection test in detecting pulomonary tuberculosis with negative spuntumcultivations.Methods:The three methods were used to detect 42 pulmonary tuberculosis patients with negative spuntumcultivations,46 pulmonary tuberculosis with positive bacillus and 36 normal persons.Results:The sensitivity and specificity of a single test were as follows:LAM 67.4%,94.4%;PCR 95.7%,97.2%;PPD 56.5%,97.2%;and the detection rate of a single test were as follows:PCR 47.6%,LAM 31.0%,PPD 21.4%.The detection rate of combined method was obviously higher than that of the single test and its specificity was more than 90%.Conclusion:The combination had an increased detection rate and better specificity in detecting pulmonary tuberculosis with negative spuntumcultivations.