| In recent years, the tuberculosis(mostly a tuberculosis) epidemic situation is gradually rigorous in scope in the world, especially appeared to bear many medicines and bear more medicine tuberculosis. The human body is infected tubercle branch rod bacteria after, whole body can be taken bad, but mainly be delivered to more lung. The tuberculosis sufferer usually only had low hot, tired and emaciated etc. general symptom in early days, the traditional tuberculosis diagnosed means like X-light check and phlegm liquid microbiology’s checking etc. often can’t get explicit diagnosis and result in many tuberculosis sufferers diagnosing the delay of treatment. Therefore, how the accurate diagnosis, insulation in time and treatment carrying out tuberculosis were the points that the tuberculosis prevents and cures a research in early days.The laboratory of tuberculosis(many for the tuberculosis) diagnoses an examination method to mainly involve professions, such as microbiology, immunology, molecular biology and pathology...etc., among them, the immunology method has quickly, simple, examination instrument cheapness etc. characteristics, be easy to be controled and make widely available. Currently, the in common use immunology examination method includes the tubercle germ the vegetable skin to try to check(TST), tubercle antibody the examination(the knot is clearly three) and γ-interferon release experiment(QFT method, T-SPOT method) etc. Above-mentioned three kinds of methods all have certain diagnosis value to the TB, each have certain merit and shortcoming, aim at list the research of method have already had parts of cultural heritages to report at home and abroad, but several contrasts of methods analyze to study cultural heritage to report less, this research aim just carries on to the above-mentioned method comprehensive the contrast analyze a research, can unite application to provide for rapid diagnosis and examination method of tuberculosis(many is tuberculosis) basis.Purpose: To tubercle germ vegetable the skin try to check(TST), tubercle antibody examination(the knot is clearly three), the γ-interferon release experiment(QFT method, T-SPOT method) match aspects like rate to carry on in the particularity, sensitivity and diagnosis comprehensive the contrast analyze a research and find out the merit and shortcoming of each method; Look for to aim at a consociation with fast- examining different clinical symptom tuberculosis(is many for the tuberculosis) method application project, and for experiment result of comprehensive analysis lay foundation; Look for three kinds of above-mentioned examination method improvement to suit a point.Method: This topic were subjects of 200 cases, 70 cases of pulmonary tuberculosis patients(for he bei province chest hospital between January 2014 and June 2014 diagnosed between 16 ~ 75 tuberculosis patients, including 40 cases, the tuberculosis bacteria Yin, 30 cases of tuberculosis bacteria diagnostic criteria accord with the Chinese medical association in 2001 to develop guidelines for tuberculosis diagnosis and treatment of tuberculosis, the diagnosis standards); Other 30 patients with lung diseases [all of TB patients and there is no history of tuberculosis, pneumonia in 15 cases, diagnostic criteria in 2006 formulated the Chinese medical association respiratory neurology, community-acquired pneumonia in adults diagnostic criteria for the diagnosis and treatment guidelines; lung cancer 15 cases, diagnostic criteria in accordance with the latest specification of primary lung cancer diagnosis and treatment(2011 edition)]; Healthy check-up 20 cases; The medical establishment that decide a dot medical staff, 80 cases of tuberculosis(40 cases of tuberculosis area health care providers, and other units, auxiliary departments, administrative personnel, a total of 40 cases). All subjects parallel implementation of the tuberculin skin test(TST), tuberculosis antibody detection(" Ming three), gamma interferon release test(QFT method, T- SPOT) testing, all test data to make use of SPSS13.0 software version number statistical analysis, from aspects of the degree of sensitivity, specific, diagnostic coincidence rate study on comprehensive comparison and analysis of the above methods.Result:1 Theer kinds of different methods to the sensitivity that the tubercle diagnoses and especially the difference, diagnosis matches rate and sun, feminine gender however ratio, 70 tuberculosis sufferers and 30 other lung departments disease the sufferer win, tubercle germ vegetable the skin try to check(TST), tubercle antibody the examination(the knot is clearly three) and γ-interferon release experiment(QFT method, T-SPOT method) examination tubercle of the sensitivity distinguish to 60.00%, 67.14%, 78.57% and 88.57%, the γ-interferon releases on trial(T-SPOT method) sensitivity to compare a TST method, the tubercle antibody examination(the knot is clearly three) method Gao, statistics learn to relatively have difference;(P<0.05)Three kinds of methods examination tubercle of especially the difference distinguish to 13.33%, 66.67%, 76.67% and 83.33%, diagnosis match rate to distinguish to 46.00%, 67.00%, 78.00% and 88.00%, masculine gender however ratio(+LR) distinguish are 0.69, 2.01, 3.37, 5.31, feminine gender however ratio(-LR) distinguish are 3.10, 0.49, 0.38, 0.21, TST examines tubercle of especially the difference, diagnosis match a rate, masculine gender however compare two kinds of other methods all low, TST feminine gender however compare two kinds of other methods high, statistics learn to relatively have difference(P<0.05).2 Theer kinds of different methods associately experiment and establish to experiment examination tubercle of sensitivity is 53.62%, especially difference is 86.67%; Merge to experiment the sensitivity of examining the tubercle as 90.00%, especially difference is 85.71%.3 Theer kinds of different methods to different crowd latent sex tubercle infection screen of masculine gender rate, in 100 different crowds, the masculine gender rate of a few method examinations distinguishes to 58.00%, 35.00%, 18.00% and 10%, the γ-interferon releases an on trial(T-SPOT method) masculine gender rate to compare a TST method, the tubercle antibody examination(the knot is clearly three) method low, statistics learn to relatively have difference(P<0.05), masculine gender the rate and crowd is more opposite than tubercle germ of the revelation degree present just related.Conclusions:1 For tuberculosis(TB) diagnosis value, comprehensive comparison from high to low in turn release test:the γ-interferon releases,tuberculosis antibody, TST. Including tuberculosis antibody detection has high specific degrees but no obvious advantages, the sensitivity of false positive TST is simple but easy to happen, release gamma interferon sensitivity test specific degree, have advantage but a high cost.2 In incubating sex tubercle germ infected person screening out, the γ-interferon releases experiment compare other two kinds of methods particularity Gao, examine masculine gender rate and crowd is more opposite than tubercle germ of revelation degree become just related.3 Three methods on the joint application of joint test for TB diagnosis value of no significant difference, but from the method is convenient and cost aspects into account, can choose according to different purpose or combination of different methods. |
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