荧光定量PCR技术在痰结核菌检测中的应用  

The application of fluorescence quantitative PCR in detection of sputum

作　　者：杨洪毅[1] 石洁[2] 刘国栋 赵玉玲[2] 李辉[2] 

机构地区：[1]郑州大学第一附属医院,河南郑州450052 [2]河南省疾病预防控制中心 [3]新乡市结核病防治所

出　　处：《现代预防医学》2013年第8期1483-1484,共2页Modern Preventive Medicine

基　　金：河南省医学科技攻关项目(201003140)

摘　　要：目的比较荧光定量聚合酶链反应(FQ-PCR)技术与痰涂片抗酸染色、改良罗氏培养法在检测结核分枝杆菌的灵敏度和特异性,探讨FQ-PCR检测痰标本中结核分枝杆菌的应用价值。方法对240例临床确诊的肺结核病患者和107例非结核呼吸系统疾病患者的痰标本分别应用FQ-PCR法、痰涂片抗酸染色法、改良罗氏培养法检测结核分枝杆菌;另用FQ-PCR法检测14例非结核分枝杆菌DNA以评价该方法对非结核分枝杆菌检测的特异性。结果 FQ-PCR检测结核分枝杆菌的敏感性分别为52.1%(125/240),明显高于抗酸染色法的24.2%(58/240)和改良罗氏培养法的35.4%(85/240),χ2=39.36,P﹤0.01;FQ-PCR法对14例非结核分枝杆菌检测结果全部为阴性,特异性为100%。结论 FQ-PCR是一种快速、敏感性高、特异性强的结核分枝杆菌辅助诊断方法,并且可以有效地鉴别非结核分枝杆菌感染,在肺结核的临床实验室诊断上有重要的应用价值。OBJECTIVE To compare the sensitivity and specificity of the three methods-fluorescence quantitative PCR, acid - fast staining of sputum smear, culture with Lowenstein Jensen （L - J） medium and to evaluate the application value of fluores- cence quantitative PCR in clinical detection of mycobacterium tuberculosis in sputum smear. METHODS The specimens of sputum were from 240 clinically diagnosed tuberculosis patients and 107 patients with non - tuberculosis respiratory system disease, which were detected by fluorescence quantitative PCR, acid - fast staining of sputum smear, culture with Lowenstein Jensen （L - J） medium, respectively, additionally, using FQ-PCR method detected 14 cases of non-tuberculous mycobacterial DNA to evaluate the specificity of the method of non-tuberculous mycohacteria detection. RESULTS The positive rates and specificity of fluorescence quantitative PCR, acid - fast staining, culture with Lowenstein Jensen （L - J） medium were 52.1% （125/240）, 24.2% （58/240）, 35.4% （85/240） respectively. The positive rates by FQ - PCR were higher than those of acid - fast stain and culture with L - J medium. CONCLUSION Fluorescence quantitative PCR is a rapid method for diagnosis tuberculosis, which shows high specificity and sensitivity. It is a useful tool for TB clinic diagnosis.

关 键 词：结核分枝杆菌 痰涂片 培养 荧光定量PCR 

分 类 号：R378.911[医药卫生—病原生物学]