实时荧光定量聚合酶链反应检测结核分枝杆菌在结核性脑膜炎诊断中的价值

目的探讨实时荧光定量聚合酶链反应(PCR)法检测结核分枝杆菌在结核性脑膜炎诊断中的价值。方法对181例临床确诊的结核性脑膜炎患者、可疑结核性脑膜炎患者和非结核性脑膜炎患者的脑脊液标本采用涂片、实时荧光定量PCR 2种方法进行检测,对其结果进行对比分析。结果 181例脑脊液标本中,脑脊液涂片检测阳性率为2.21%(4/181),PCR检测阳性率为12.15%(22/181);脑脊液涂片、PCR法检测51例临床确诊的结核性脑膜炎患者脑脊液标本阳性率分别为5.88%(3/51)和25.49%(13/51);检测80例临床可疑结核性脑膜炎患者脑脊液标本阳性率分别为1.25%(1/80)和11.25%(9/80),2种方法的阳性检测率比较差异有统计学意义(χ2=10.654,P<0.05)。50例非结核性脑膜炎患者脑脊液标本涂片及PCR检测均为阴性。结论实时荧光定量PCR法检测结核分枝杆菌具有较高的临床价值,可作为临床结核病检测诊断的有效方法之一。

Diagnostic value of real time fluorescent quantitation polymerase chain reaction for detecting the mycobacterium tuberculosis in diagnosis of tuberculous meningitis

Objective To investigate the value of real time fluorescent quantitation polymerase chain reaction(PCR)which detected the mycobacterium tuberculosis in the diagnosis of tuberculous meningitis.Methods Smear and real time fluorescent quantitation PCR methods were used to detect cerebrospinal fluid samples of 181 patients who were clinically diagnosed tuberculous meningitis,suspected tuberculous meningitis as well as suffered non-tuberculous meningitis.Meanwhile,the results were analyzed.Results In the sample of 181 cerebrospinal fluid,the positive rate detected by cerebrospinal fluid smear method was 2.21%(4/181)and the positive rate detected by real time fluorescent quantitation PCR method was 12.15%(22/181).The cerebrospinal fluid specimens positive rates of 51 cases clinically definited tuberculous meningitis detected by smear and real time fluorescent quantitation PCR assay were 5.88%(3/51)and 25.49%(13/51)respectively.And in the 80 cases of suspected tuberculous meningitis patients,the positive rates were 1.25%(1/80)and 11.25%(9/80)respectively.The difference of the positive detection rate between the two methods was statistically significant(χ2=10.654,P<0.05).Cerebrospinal fluid specimens of 50 cases with non-tuberculous meningitis detected by smear and real time fluorescent quantitation PCR methods were both negative.Conclusion Detection of mycobacterium tuberculosis with real time fluorescent quantitation PCR method has high clinical application value,and it can be used as one of effective methods of clinical tuberculosis detection and diagnosis.