结核分枝杆菌荧光定量聚合酶链反应对结核性脑膜炎的早期诊断价值  

The Early Diagnostic Value of Mycobacterium Tuberculosis Fluorescence Quantitative PCR in Tuberculous Meningitis

作　　者：吴睿彦[1] 陈志成[1] 肖芃[1] 邱薇[1] 陈品儒[1] 王维勇[1] 岑文昌[1] 陈慧玉[1] 

机构地区：[1]广州市胸科医院重症结核科1内科,510095

出　　处：《实用医学杂志》2012年第17期2867-2869,共3页The Journal of Practical Medicine

摘　　要：目的:探讨荧光定量聚合酶链反应(荧光定量PCR)检测技术对诊断结核性脑膜炎的应用价值。方法:对165例确诊为结核性脑膜炎患者和38例非结核性脑膜炎患者行腰椎穿刺术,标本送检结核分枝杆菌的荧光定量PCR、结核分枝杆菌培养、涂片找抗酸杆菌,比较各种检测方法的敏感性和特异性。结果:荧光定量PCR反应检测阳性率52.7%,明显高于脑脊液涂片找抗酸菌(1.2%)及结核分枝杆菌培养(11.5%)。荧光定量PCR与抗酸杆菌培养方法对比,P<0.01,差异有统计学意义,PCR检测明显优于细菌学培养。结论:结核分枝杆菌的荧光定量PCR对结核性脑膜炎诊断特异性高,分析周期短,在早期诊断结核性脑膜炎方面有重要的参考价值。Objective The objective of this paper is to discuss the application value of fluorescence quantitative PCR in detection of tuberculous meningitis. Methods 203 tuberculous meningitis patients were operated lumbar puncture. The samples were detected by mycobacterium tuberculosis fluorescence quantitative PCR, mycobaeterium tuberculosis culture and smear microscopy to find acid-fast bacilli. Then detection sensitivities and speeificities of these methods were compared. Results The positive rate in fluorescence quantitative PCR to find acid-fast bacilli was 52.7%, much higher than 1.2% in cerebrospinal fluid smear microscopy and 11.5% in mycobacterium tuberculosis culture. Comparing fluorescence quantitative PCR with the method of mycobacterium tuberculosis culture, P 〈 0.01, differences has statistically significant, which shows fluorescence quantitative PCR is better than mycohacterium tuberculosis culture. Conclusion Fluorescence quantitative PCR of myeobactefium tuberculosis in the diagnosis of tuberculous meningitis is with a high specificity and a short annalistic period. It is of important reference value in the early diagnosis of tuberculous meningitis.

关 键 词：结核 脑膜 结核分枝杆菌 聚合酶链反应 

分 类 号：R529.3[医药卫生—内科学]