結(jié)核病（tuberculosis，TB）是由結(jié)核分枝桿菌（Mycobacterium tuberculosis，MTB）引起的一種人獸共患慢性傳染病，其早期診斷和檢測非常困難。常規(guī)的TB實(shí)驗(yàn)室檢測技術(shù)主要是痰涂片和痰培養(yǎng)，這是診斷肺結(jié)核的金標(biāo)準(zhǔn)，但均有一定的局限性，故對其優(yōu)化和改良是目前TB檢測研究的一個重要方向，目前主要集中在硬件設(shè)備的升級改造上。近年來，TB實(shí)驗(yàn)檢測診斷技術(shù)發(fā)展較快。核酸擴(kuò)增方法成為TB診斷研究的新方向，包括環(huán)介導(dǎo)等溫?cái)U(kuò)增（loop-mediated isothermal amplification method，LAMP），結(jié)核分枝桿菌/利福平耐藥實(shí)時熒光定量核酸擴(kuò)增（Xpert Mycobacte-rium tuberculosis/Rifamfampin，Xpert MTB/RIF），交叉引物恒溫?cái)U(kuò)增（crossing priming amplification，CPA），實(shí)時熒光恒溫?cái)U(kuò)增（simultaneoous amplification and testing method，SAT）以及PCR技術(shù)等。免疫學(xué)檢測技術(shù)是TB檢測的另一個重要發(fā)展方向，現(xiàn)已研制出兩種快速檢測方法T-SPOT.TB和QuantiFERON-Gold test（QFT）。還有一些新技術(shù)正在研發(fā)中，如基質(zhì)輔助激光解吸電離飛行時間質(zhì)譜（matrix-assisted laser desorption/ionization time of flight mass spectrometry，MALDI-TOF-MS）以及代謝標(biāo)記檢測、納米孔測序等。TB檢測手段正由傳統(tǒng)的細(xì)菌學(xué)檢查轉(zhuǎn)向免疫、分子診斷等更為精確的方法。然而，不同診斷方法均有局限性，在實(shí)際應(yīng)用中需采用多種檢測方法相結(jié)合的方式。本文對于全面了解多種TB檢測技術(shù)的優(yōu)點(diǎn)和局限性，從而選擇合適的檢測方法具有幫助意義。
Research Progress on Laboratory Technologies for Detection of Tuberculosis
Tuberculosis（TB）is a chronic zoonosis caused by mycobacterium tuberculosis（MTB），which is very difficult to diagnose and detect at its early stage. Fortunately，the technologies of TB laboratory testing and diagnosis has been developing rapidly in recent years. As the main conventional testing technologies，smear and cultivation of sputum are gold standards，but both of the two technologies have some limitations，hence，their optimization and improvement have become the important direction for TB testing，with an emphasis on upgrading of related hardware equipment. In order to solve such limitations，nucleic acid amplification methods have been studied and explored，including Loop-mediated Isothermal Amplification（LAMP），Xpert Mycobacterium tuberculosis/Rifampin（Xpert MTB/RIF），crossing priming amplification（CPA），simultaneous amplification and testing（SAT）and PCR. Immunological assays are also used for TB testing，in which，T-SPOT.TB and QuantiFERON-Gold test（QFT）have been already developed. Other new technologies are also in development，such as Matrix-assisted laser desorption ionization time-of-flight mass spectrometry（MALDI-TOF-MS），metabolic marker testing，nanopore sequencing，etc. At present，TB testing methods are turning to immunoassay，molecular diagnosis and other more accurate methods from traditional bacteriological testing. However，all the above methods are limited，therefore different technologies should be used together in practice. In conclusion，the advantages and limitations of various TB testing technologies were summarized，which would help to select appropriate method in practice.
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