荧光PCR诊断肺结核的临床应用研究

目的对荧光PCR(FQ-PCR)、痰涂片、结核抗体血清学试验及痰培养在肺结核诊断上进行方法学评价。方法 FQ-PCR、痰涂片及痰培养四种方法对结核组(124例)及非结核组(119例)进行检测,对四种方法进行方法学评价。结果结核组中荧光PCR、痰涂片、痰培养、血清学试验四种方法检出率分别为58.9%、30.6%、47.5%及66.1%,差异有统计学意义(P0.01),其中以血清学试验及荧光PCR检出率较高;在非结核组中,荧光PCR、痰涂片、痰培养三种方法均未检测出阳性结果,血清学试验检测出12例阳性;四种方法的方法学评价:灵敏度、约登指数、符合率、阴性预测值以荧光PCR、血清学试验较高,特异度、阳性预测值荧光PCR、痰涂片、痰培养均为100%,综合各项指标以荧光PCR方法较好。结论荧光PCR具有较高的灵敏度、特异度,快速、简单,在肺结核的诊断上具有较大的优势,适合在临床推广应用。

Clinical application of fluorescent quantitative PCR in the diagnosis of tuberculosis

Objective To evaluate the clinical application of fluorescent quantitative PCR （ FQ-PCR） , spu-tum smear, tuberculosis antibody serological tests and sputum culture in the diagnosis of pulmonary tuberculosis. Methods The above mentioned four methods were performed in the tuberculosis group （124 cases） and the non-tu-berculosis group （119 cases）. The results were evaluated. Results The detective rate of FQ-PCR, sputum smear, sputum culture, and serological test was 58. 9%, 30. 6%, 47. 5% and 66. 1% respectively in the tuberculosis group （χ2 =35. 75, P〈0. 01）. In the non-tuberculosis group, FQ-PCR, sputum smear, and sputum culture had no posi-tive results, and serological test showed 12 cases positive. FQ-PCR and serological test had a high sensitivity, Youden index, compliance rate, and negative predictive value. FQ-PCR, sputum smear, sputum culture had 100%of specificity and positive predictive value. Conclusion FQ-PCR has the advantages of high sensitivity and specifici-ty. It is fast and simple in the diagnosis of pulmonary tuberculosis.