运用PCR及ABC－ELISA法早期诊断结核性脑膜炎的评价

收集了４１例结核性脑膜炎（结脑）患者和３０例非结脑患者脑脊液，运用ＰＣＲ法扩增结核蛋白抗原Ｂ上ＤＮＡ序列４１９ｂｐ片段，用ＡＢＣ－ＥＬＩＳＡ检测抗结核蛋白抗体。结脑组ＰＣＲ阳性率７５．７％（３１／４１），抗结核抗体阳性率６３．５％（２６／４１）；对照组ＰＣＲ全部阳性，抗结核抗体阳性率１３．３％。ＰＣＲ阳性可在发病第２天查到且在治疗６个月时仍可见ＰＣＲ阳性。随病程延长抗体阳性率上升。运用ＰＣＲ及ＡＢＣ－ＥＬＩＳＡ法早期诊断结脑快速而敏感，两法同时应用可提高阳性率。

Evalution of Early Diagnosis of Tuberculous Meningitis by PCR and Enzyme-linked Immunosorbent Assay

Cerebrospinal fluid(CSF )were collected from 41 patients with tuberculous meningitis(TBM )and 30 patients with other neurologic disorders(OND).We detected the 419-base pair sequence of protein antigen B of M. tuberculosis by PCR and antibody against M. tuber culosis protein(TBPab)by avidin-biotin enzyme-linked immunosorbent (ABC-ELISA),in TBM group, the rate of positive was 75.7%(PCR), 63.5%(ABC-ELISA), respectively. In control group, none of the specimens was PCR positive, while 4 of 30 cases from control patients were positive for TBPab. The results were showed that PCR positive at the second day of onset and was still observed during the six monthes of therapy. The rate of positive of TBPab in CSF was increase with the course of disease. We concluded that PCR and ABCELISA were sensitively and rapid in early diagnosis of TBM. The positive rate will be increase by combining PCR and ABC-ELISA.