荧光定量PCR对痰涂片阴性肺结核的临床诊断价值  

Clinical value of TB-DNA in BALF detected by FQ-PCR in diagnosing smear-negative pulmonary tuberculosis

作　　者：李苏梅[1] 包紫薇[1] 唐佩军[1] 王霞芳[1] LI Su-mei;BAO Zi-wei;TANGPei-jun;WANGXia-fang(the Fifth People’ s Hospital of Suzhou,Suzhou215000,China)

机构地区：[1]苏州市第五人民医院结核病科,江苏苏州215000

出　　处：《临床肺科杂志》2018年第6期977-979,共3页Journal of Clinical Pulmonary Medicine

基　　金：苏州市临床重点病种诊疗技术专项项目(No LCZX201514);苏州市科技局民生项目(No SS201541;No SS201656);江苏省青年医学人才项目(No QNRC2016226)

摘　　要：目的探讨荧光定量PCR检测对痰涂片阴性的肺结核的诊断价值。方法采集180例痰涂片阴性的肺结核病患者及100例非结核性肺部疾病患者(肺炎、肺癌及矽肺患者)的支气管灌洗液(BALF),应用荧光定量PCR检测BALF中的TB-DNA,同时进行BALF结核杆菌培养及抗酸染色法检查结核杆菌,比较不同方法对肺结核的临床诊断效率。结果肺结核组中BALF中TB-DNA阳性检出率为62.77%,显著高于BALF抗酸染色法的阳性检出率33.89%(P<0.05),与BALF结核杆菌培养法无明显统计学差异(P>0.05),治疗1个月后TB-DNA的阳性检出率也高于抗酸染色法(P<0.05)。结论荧光PCR定量检测TB-DNA能提高结核杆菌的检出率,可作为诊断及判断疗效的方法。Objective To study the clinical value of TB-DNA in BALF detected by FQ-PCR in diagnosing smear-negative pulmonary tuberculosis. Methods FO-PCR was used to detect the TB-DNA in BALF from 180 smear-negative pulmonary TB patients and 100 patients with pneumonia,lung cancer or silicosis. Besides,tubercle bacillus culture and acid fast bacilli use BALF were also processed at the same time. Results The positive rate of TB-DNA in BALF was 62. 77% in the pulmonary tuberculosis group,which was significantly higher than 33. 89% of acid fast staining method（ P〈0. 05）,but had no obvious statistical difference with bacterial culture method（ P〉0. 05）. 1 months after treatment,the positive detection rate of TB-DNA was higher than that of acid fast staining method（ P〈0. 05）. Conclusion FQ-PCR to detect TB-DNA in BALF can improve the detection rate and it can also be used as an indicator for medicine choice and therapeutic effect judgment.

关 键 词：结核病 支气管肺泡灌洗液 荧光定量PCR TB-DNA 

分 类 号：R446.5[医药卫生—诊断学] R521[医药卫生—临床医学]