结核蛋白芯片法检测结核分枝杆菌的临床评价

摘要

Objective To investigate the Mycobacterium tuberculosis infection status and Clinical Characteristics in Yongchuan District, Chongqing by Tuberculosis Protein Chip.Methods Compared the conventional method to detect Mycobacterium tuberculosis in infectious department outpatient of Yongchuan Hospital , Chongqing Medical University from July 2014 to June 2015.Tuberculosis protein chip was selected to detect the Mycobacterium tuberculosis infection in Yongchuan area.Chi-square Test was applied to analyze the results.Results The positive rate of Tuberculosis Protein Chip, T-SPOT.BT, DNA Chip, Golden immnnochromatog-raphy, Acid-fast staining were 81.5%, 90.7%, 89.5%, 63.5% and 38.3%respectively on 162 cases of Pulmonary tuberculosis.The five methods were considered significant difference on the diagnosis of Pulmonary tuberculosis ( P<0.05 ).The positive rate of Tuberculosis Protein Chip, T-SPOT, Golden immnnochromatog-raphy were 90.6%,T-SPOT 94.3%and 47.2% respectively on 53 cases of extrapulmonary tuberculosis, it was a significant difference with the three methods(P<0.05),but there was no significant difference with Tuberculosis Protein Chip and T-SPOT.BT ( P>0.05 ).The highest positive rates of anti-LAM was 94%.Conclusion The results of Tuberculosis protein chip are reliable on pulmonary tuberculosis and extrapulmonary tuberculosis diagnosis.%目的：采用结核蛋白芯片法检测结核分枝杆菌感染，分析重庆市永川地区的结核感染现状以及流行病学趋势。方法2014年7月至2015年6月来重庆医科大学附属永川医院感染科门诊就诊患者，对635例疑似结核分枝杆菌感染患者采用临床常用结核分枝杆菌检测方法进行检测，通过结核蛋白芯片法检测永川地区结核分枝杆菌感染情况。共计215例患者被临床确诊为结核分枝杆菌感染，其中肺结核162例，肺外结核53例。采用卡方检验，对检测结果进行统计学分析。结果162肺结核患者，蛋白芯片法阳性率为81.5％，T-SPOT.BT为90.7％，DNA微阵列芯片89.5％，金标法为63.5％，抗酸染色法为38.3％。5种检测方法在临床肺结核诊断上差异有统计学意义（ P＜0.05）。53例肺外结核患者，蛋白芯片法阳性率90.6％、T-SPOT为94.3％、金标法为47.2％。3种检测方法在阳性率比较上差异有统计学意义（ P＜0.05）。蛋白芯片法、T-SPOT.BT在肺外结核阳性率上差异无统计学意义（ P＞0.05）。结核蛋白芯片法LAM抗体阳性出现概率最大为94％。结论结核蛋白芯片法对肺结核和肺外结核的诊断较为可靠。（中华检验医学杂志，2016，39：780-782）