结核杆菌RNA、结核杆菌DNA及γ-干扰素释放试验联合检测对菌阴性肺结核的诊断价值

目的 探讨结核杆菌RNA(TB-RNA),结核杆菌DNA (TB-DNA)及r干扰素释放试验(IGRA)联合检测对菌阴性肺结核的诊断价值.方法 选择自2011年1月至2015年12月河北省胸科医院住院或门诊期间疑诊为肺结核的212例患者,根据痰涂片或痰培养结果分为初治菌阴性肺结核组(n =94)和初治菌阳性肺结核组(n=72)及非结核疾病组(n=46),分别行TB-RNA、TB-DNA、IGRA检测,对各检测结果进行对比,并行TB-RNA、TB-DNA、IGRA联合检测结果与单用检测对比分析.结果 ①单项检测中TB-RNA、TB-DNA、IGRA对初治菌阳对照组的敏感度分别为56.9％,65.3％,81.9％;特异度分别为97.8％,95.8％,97.8％;②单项检测对菌阴肺结核的检出率相应为:50.0％,54.3％,77.7％;③联合检测对菌阴肺结核的检出率为88％,均明显高于单项检测.结论 TB-RNA、TB-DNA、IGRA联合检测提高了菌阴肺结核的检出率.

Detection of TB-RNA,TB-DNA combined with interferon gamma release assay in the diagnosis of smear negative Tuberculosis

Objective To analyze the value of smear negative Tuberculosis diagnosis by detecting TB-RNA,TB-DNA combined with interferon gamma release assay (IGRA).Methods 212 suspected pulmonary Tuberculosis patients were confirmed and divided into 3 groups in Hebei Provence Chest Hospital from January 2011 to December 2015.The group A had 94 cases of smear negative Tuberculosis,the group 1B had 72 cases of smear positive Tuberculosis,and the group C had 46 cases of non-Tuberculosis respiratory.The 3 groups were given TB-RNA,TB-DNA combined with IGRA,and the diagnosis value of single and joint examination for 3 groups were evaluated.Results ①In single examination sensitivity of TB-RNA,TB-DNA and IGRA was 56.9％,65.3％,81.9％;respectively specificity was 97.8％,95.8％,97.8 ％;②The positive detection rate of single examination for smear negative Tuberculosis was 50.0％,54.3％,77.7％;③The combination examination for smear negative Tuberculosis was 88％.It was obvious higher than single examination.Conclusions It is valuable for widely use of combination method in detection of smear negative Tuberculosis.