肺结核、肺癌患者外周血结核分枝杆菌及其L型的检测方法  

Comparison of five methods for detection of Mycobacterium tuberculosis and their L－forms in peripheral blood of pulmonary tuberculosis and lung cancer patients

作　　者：朱明利[1] 张元和[2] 李明君[2] 黄礼年[3] 王恩举[4] 林特夫[2] 姚敏[5] 

机构地区：[1]蚌埠医学院附属医院检验科 [2]蚌埠医学院附属医院微生物学教研室 [3]蚌埠医学院附属医院呼吸内科,安徽蚌埠233004 [4]蚌埠铁路中心医院内科,安徽蚌埠233040 [5]蚌埠医学院附属医院病理学教研室,安徽蚌埠233003

出　　处：《蚌埠医学院学报》2001年第1期71-73,I002,共4页Journal of Bengbu Medical College

基　　金：安徽省教育厅科研课题资助项目!(96JL0086)

摘　　要：目的：建立检测血液中结核分枝杆菌及其L型的简便方法，并对其临床应用进行评价。方法：将红细胞裂解后离心检测，建立PCR法、直接培养法、溶血离心培养法、溶血离心涂片法和滴片法。结果：13例肺结核和25例肺癌患者中，肺结核和肺癌患者外周血结核分枝杆菌PCR检测的阳性数为8例中3例和11例中3例；结核分枝杆菌及其L型直接培养法总阳性率为17.65%，溶血离心涂片法、溶血离心培养法、滴片法的总阳性率分别为9.52%、41.18%和58.82%；肺结核和肺癌患者外周血结核分枝杆菌以L型为主，表现为抗酸或非抗酸。结论：肺结核和肺癌患者外周血存在结核分枝杆菌及其L型，并以L型为主；溶血离心培养法和滴片法结合免疫酶染色可常规用于检测血液中结核分枝杆菌及其L型。Objective:To establish five new methods of d etecting Mycobacterium tuberculosis and their L－forms in peripheral blood,and evaluate their clinical practicabilities.Methods:Cultivation,smear and drop－slide examinations of hemolyzed blood after centrifugation were used for detection of Mycobacterium tuberculosis and their L－forms from peripheral blood.Results:In 25 cases of lung cancer and 13 cases of pulmonary tubercu losis,the positive cases of PCR in peripheral blood were 3 of 11 and 3 of 8 resp ectively.In all cases the positive rates detected by direct blood culture,and by t he smear,blood culture and drop－slide examination of hemolyzed blood were 17.65 %,and 9.52%,41.18% and 58.82% respectively.Most of the organisms found were main ly in L－forms,acid fast or even non－acid－fast in staining.Conclusions:Mycobacterium tuberculosis and their L－forms exist in peripheral blood of patients with pulmonary tuberculosis and lung cancer,and main ly in L－forms.Cultivation with hemolyzed－centrifugated blood in liquid medium and drop－slide examination and staining with immunoenzyme technique are valuabl e in routine detection of Mycobacterium tuberculosis and their L－forms in p eripheral blood.

关 键 词：结核分枝杆菌 细菌L型 微生物学 肺结核 肺肿瘤 

分 类 号：R521[医药卫生—内科学] R734.2[医药卫生—临床医学]