聚合酶链反应对菌阳肺结核治疗的监测  

Polymerase chain reaction technique in monitoring treatment of bacillary pulmonary tuberculosis

作　　者：安素芳[1] 樊玉华[1] 

机构地区：[1]广州市胸科医院内科

出　　处：《中华结核和呼吸杂志》1998年第7期392-394,共3页Chinese Journal of Tuberculosis and Respiratory Diseases

摘　　要：目的探讨痰菌阳性肺结核患者在治疗期及停药２年内痰结核分支杆菌及其ＤＮＡ阴转情况与复发的关系以及聚合酶链反应（ＰＣＲ）对菌阳肺结核患者治疗的监测价值。方法用ＰＣＲ技术、涂片及培养法对８７例菌阳肺结核于治疗期每月检测１次，停药期继续随访２年。结果痰结核分支杆菌ＰＣＲ转阴时间通常比涂片和培养迟１～３个月，痰含菌量越多，ＰＣＲ持续阳性时间越长。８７例中１０例（１１％）ＰＣＲ持续阳性１年以上，其中３例（３０％）分别于停药后８、１２、１６个月时复发，１例ＰＣＲ已转阴病例于１８个月时复发。此４例均有痰菌复阳，胸片示病灶增多而再次接受治疗。结论ＰＣＲ用于临床疗效观察比涂片、培养实用，对估计有可能复发的病例有一定帮助。Objective To explore the relationship between sputum Mycobacterium tuberculosis as well as its DNA negative conversion and relapse in bacillary pulmonary tuberculosis during chemotherapy and 2 years after completion of treatment, and to evaluate the value of polymerase chain reaction (PCR) technique in monitoring the efficacy of treatment. Method Eighty seven patients with bacillary pulmonary tuberculosis were monthly examined by PCR technique, smear and culture methods, and were followed up for 2 years after treatment. Result The duration of sputum negative conversion by PCR technique was 1～3 months later than that by smear and culture methods. The more the sputum bacteria, the longer the duration of PCR positive results. Positive PCR results maintained in 10 out of 87 patients for more than 1 year, among them 3 (30%) relapsed respectively at 8, 12 and 16 months after treatment. One PCR negative conversion case relapsed at 18 months after treatment. These 4 cases who regained sputum positive results and showed deterioration in chest X ray films were admitted to hospital again. Conclusion PCR technique is more practical than smear and culture methods in monitoring efficacy of the treatment of bacillary pulmonary tuberculosis, and is useful for evaluating cases with possible relapse.

关 键 词：肺结核 药物疗法 聚合酶链反应 监测 

分 类 号：R521.05[医药卫生—内科学]