五种结核病实验室检测方法对结核病诊断价值的效果评价

目的评价涂片法、BACTECMGIT960快速培养法、改良罗氏培养法、荧光定量PCR法和斑点免疫层析法在结核病实验室快速诊断方法中的作用和地位。方法对1260例结核病患者（结核病组）和100例非结核病患者（非结核病组）的各类标本采用涂片法、快速培养法、改良罗氏培养法、荧光定量PCR法进行检测，同时分离患者外周血血清进行结核抗体检测，并对这五种检测方法的结果进行分析比较。结果五种实验室检测方法对结核病组阳性标本和非结核病组阴性标本的检测结果差异均有统计学意义（χ2=466．31,χ2=216．14，P均〈0．05）。对于结核病组的涂阳和涂阴标本，快速培养法和荧光定量PCR法检测的灵敏度及准确度均高于其他三种方法，而涂片法、改良罗氏培养法、快速培养法的特异性均为100．0％，高于荧光定量PCR法和斑点免疫层析法；快速培养法的阳性检出率均较改良罗氏培养法高，差异均有统计学意义（χ2=3387．00,χ2=4233．00，P均〈0．05），平均培养时间也较改良罗氏培养法短；但快速培养法与荧光定量PCR法的阳性检出率差异均无统计学意义（P均〉0．05）。结论BACTECMGIT960快速培养法和荧光定量PCR法是诊断结核病快速、有效的检测方法，其阳性检出率高，且能缩短培养时间，BACTECMGIT960快速检测系统还能进行快速药物敏感性试验，为结核病的快速诊断提供依据。

Clinical evaluation on the detection of tuberculosis by five methods

Objective To evaluate the diagnosis value of smear method, BACTEC MGIT 960 rapid culture method, improved roche culture method, fluorescent quantitative PCR method and dot immunochro- matographic assay to detected tuberculosis. Methods The clinical specimens of 1260 patients with tuberculo- sis（tuberculosis group） and lO0 patients with non-tuberculosis （non-tuberculosis group） were detected by smear method, rapid culture method, improved roche culture method, fluorescent quantitative PCR method, and the serum specimens of patients were detected by dot immunochromatographic assay. The results were ana- lyzed. Results There were statistically significant differences of five methods in the positive detection rates of tuberculosis group and negative detecting rates of non-tuberculosis group （χ2= 466.31 ,χ2= 216.14, Pall〈 0.05 ）. To the smear-positive specimens and smear-negatives pecimens of tuberculosis group, the sensitivity and ac- curacy of rapid method and fluorescent quantitative were all higher than other methods, but the specificity （100.0%） of rapid method, improved roche culture method and smear method were all 100.0%, which were higher than fluorescent quantitative PCR method and dot immunoehromatographie assay. The positive detect rates of rapid culture method were all higher than improved roche culture method, the differences had statisti- cal significance （χ2= 3387.00 ,）（χ2= 4233.00,Pa11〈 0.05 ）. And the average culture time of rapid culture method were shorter than improved roche euhure method. There were no statistically significant differences between rapid culture method and fluorescent quantitative PCR method in positive detection rates （Pall〉 0.05 ）. Con- clusion BACTEC MGIT 960 rapid culture method and fluorescent quantitative PCR method were fast and ef- fective detection methods. They had a high postive deetection rates, and could shorten culture time, BACTEC MGIT 960 rapid detection system also could make rapid drug sensitivity test, and provide the basis for the rapid diagnosis of tuberculosis.