聚合酶链反应与分离培养技术检测结核分支杆菌诊断关节结核的对照研究

目的：研究聚合酶链反应（polymerase chain reaction，PCR）技术在关节结核标本结核分支杆菌检测方面的作用，探讨PCR技术对关节结核诊断的临床价值。方法：自1993年6月至2001年8月，对95例（男55例，女40例；年龄2～75岁）关节结核标本分别应用PCR技术和分离培养法盲法检测结核分支杆菌，计算两者检测阳性率，通过统计学处理进行比较。结果：95例关节结核标本结核分支杆菌检测中，PCR技术检测阳性78例，阴性17例，阳性率82％；分离培养法检测阳性15例，阴性80例，P13性率16％。PCR技术与分离培养法比较，Х^2=67，P〈0．001，两种方法对于关节结核标本结核分支杆菌的检出率比较差异有统计学意义。PCR扩增整个过程自动化控制，可在数小时内完成。结论：PCR技术检测关节结核标本具有快速、简便、敏感与特异等优点，明显优于分离培养，对关节结核的早期快速诊断与鉴别诊断具有较重要的临床价值。

Comparison study on polymerase chain reaction(PCR) and standard culture technique in detecting mycobacterium tuberculosis to diagnose of joint tuberculosis

Objective ：To study the role of PCR technique in detection of mycobacterium tuberculosis in the samples from joint tuberculosis, and to evaluate the clinical value of PCR in diagnosis of joint tuberculosis. Methods：From June 1993 to August 2001 ,PCR was used to detect DNA of mycobacterium tuberculosis,and the standard culture was applied to detect mycobacterium tuberculosis. Mycobacterium tuberculosis were respectively blindly by the two techniques in the samples obtained from 95 patients with joint tuberculosis （55 males and 40 females ,the age ranging from 2 to 75 years ,with an average of 34 years）. The positive rate of mycobacterium tuberculosis detection was calculated. Results：In the detection of mycobacterium tuberculosis,positive rate was 82% （78/95） in PCR technique,and 16% （15/95） in standard culture technique. There were statistical differences between the two groups （Х^2=67, P〈0.001 ）. The whole process of PCR amplification was automatic and could be finished within several hours, and the detecting time was considerably shorter. Conclusion ： PCR technique is a rapid, simple, sensitive and specific method for detection of mycobacterium tuberculosis in the samples of joint tuberculosis,showing more marked advantages than the standard culture technique. It is valuable in the early rapid diagnosis and differential diagnosis of joint tuberculosis.