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中国防痨杂志 ›› 2006, Vol. 28 ›› Issue (1): 14-17.

• 论著 • 上一篇    下一篇

四种结核分枝杆菌检测方法的临床应用评价

张翊;卢建平;叶淼;   

  1. 浙江省余姚人民医院 余姚 315400;
  • 出版日期:2006-01-10 发布日期:2006-11-03

Clinical evaluation on the detection of Mycobacterium tuberculosis by four methods

Zhang Yi,Lu Jianping,Ye Miao.   

  1. Yuyao People’s Hospital,Yuyao 315400,China
  • Online:2006-01-10 Published:2006-11-03

摘要: 目的评估涂片、培养、PCR和增菌PCR检测结核分枝杆菌临床应用价值。方法对124例临床确诊的肺结核、可疑结核患者和非结核病人痰标本的涂片、培养、PCR和增菌PCR四种方法的检测结果进行比较。结果涂片、培养、PCR和4及7d的增菌PCR检测31例临床确诊的肺结核病人痰标本阳性率分别为22.5%、32.2%、54.8%、64.5%和87.1%;检测59例临床可疑肺结核病人痰标本阳性率分别为13.6%、18.6%、28.8%、37.3%和52.5%。比较四种方法的阳性检测率有显著性差异(P<0.05)。检测34例非结核病人痰标本,涂片、培养均为阴性,而PCR和增菌PCR均有1例假阳性,假阳性率2.9%。比较PCR与增菌PCR对菌阳和菌阴病人的痰标本阳性检测率,有显著性差异(P<0.05),而两种方法的假阳性率相同。结论增菌PCR检测结核分枝杆菌具有很高的敏感性和特异性,可作为结核病的有效辅助诊断方法之一。

关键词: 结核,肺/诊断, 痰涂片, 培养, 聚合酶链反应

Abstract: Objective To evaluate the clinical application value of sputum smear,culture,polymerasechain reaction(PCR) and bacterium proliferation PCR(BP-PCR) for the detection of Mycobacterium tuberculosis.Method One hundred and twenty-four sputum specimens frompatients with pulmonary tuberculosis,suspicious pulmonary tuberculosis,and non-tuberculosiswere detected for Mycobacterium tuberculosis by four methods,and the Results from four methodswere compared.Results The positive rates for the detection of Mycobacterium tuberculosis were 22.5%,32.2%,54.8%,64.5% and 87.1% in 31 sputums from the patients with pulmonary tuberculosis by smear,culture,PCR,and BP-PCR in 4 or7 days,respectively.The positive rateswere 13.6%,18.6%,28.8%,37.3% and 52.5% in 59 samples from the patients with suspicious pulmonary tuberculosis,respectively.There was a significant difference(P<0.05) among four methods. Of 34 sputum samples from the non-tuberculous patients,all were negative by smear and culture methods,but one was positive(2.9%) by PCR and BP-PCR methods,respectively.The positive rate of BP-PCR for detection of Mycobacterium tuberculosis was significantly higher than that of the PCR,but the false positive rate had no difference.Conclusion The BP-PCR assay hadhigh sensitivity and specificity,and might be used for the diagnosis of pulmonary tuberculosis.

Key words: Pulmonary tuberculosis/diagnosis, Sputum smear, Culture, PCR