结核杆菌的细菌学、分子生物学和免疫学检测方法评价

目的比较涂片法、荧光定量PCR方法和结核抗体检测法对结核病的诊断价值。方法选取2006年7月~2010年8月期间临床确诊或怀疑结核的检样326例,进行涂片抗酸染色、荧光定量PCR检测和采集血样进行结核抗体检查。结果 326例检样中,检出TB-DNA阳性107例,阳性率32.82%。其中脓液、支气管灌洗液和痰液最高,分别为48.84%（86例）、31.71%（82例）、30.39%（102例）。抗酸染色标本痰液阳性率为9.80%,脓液25.58%,支气管灌洗液15.85%。结核抗体阳性率52.45%。抗酸染色法与荧光PCR法的符合率81.60%,而结核抗体检测法与抗酸染色法的符合率61.97%,与荧光PCR检测法的符合率为80.37%。结论三种方法中,以结核抗体法阳性率最高,荧光PCR法次之,抗酸染色法阳性率最低。三种方法联合运用,可弥补单独采用1种方法阳性率低的缺点,几种方法之间可相互佐证,从而使准确性得以提高。

Evaluation of bacteriology, molecular biology and immunology detect methods of tuberculosis

Objective Evaluation the value of bacteriology,molecular biology and immunology detect methods to tuberculosis.Methods Collecting data from July 2006 to August 2010,all of 326 samples were concluded,which both detected Mycobacterium tuberculosis and its antibody using methods of antiacid,fluorescence polymerase chain reaction and golden standard method.Results The positive sample of TB-PCR was 107 and its positive rate was 32.82%.The positive rate of TB-PCR in pus,bronchial washing fluid and sputum,was 48.84%（n=86）、 31.71%（n=82）、30.39%（n=102）appropriately.And the positive rate of antiacid method in sputum,pus and bronchial washing fluid was 9.80%,25.58% and 15.85% appropriately.The positive rate of Mycobacterium tuberculosis antibody was 52.45%.The consistency rate of antiacid method and TB-PCR detection was 81.60%.The consistency rate of antiacid method and Mycobacterium tuberculosis antibody detection was 61.97%,and TB-PCR detection and Mycobacterium tuberculosis antibody detection was 80.37%.Conclusion The most sensitive method was antibody detection,then TB-DNA detection,antiacid method was the last.Both detecting mycobacterium tuberculosis using the 3 methods we were developing would raising the accurate and sensitive rate.