实时荧光PCR检测儿童肺结核粪便中Mtb-DNA的效果评价

目的 应用实时荧光PCR快速检测肺结核患儿粪便中Mtb-DNA，并初步评估其临床效果。 方法 收集肺结核住院儿童粪便标本76份，应用实时荧光PCR检测Mtb-DNA，检测结果与20例其他呼吸系统疾病患儿的粪便实时荧光PCR检测Mtb-DNA、76例粪便抗酸杆菌涂片检查以及41例患儿痰标本的涂片和(或)培养、实时荧光PCR检测结果进行比较。 结果 粪便实时荧光PCR检测敏感度达到23.68%(18/76)，特异度为100.00％(20/20)，肺结核患儿粪便PCR阳性率［23.68%(18/76)］明显高于涂片阳性率［6.58%(5/76)］，41例患儿中痰涂片和(或)培养阳性例数(15例)和痰PCR检测阳性例数(18例)高于粪便PCR检测阳性例数(11例)。 结论 实时荧光PCR检测儿童粪便Mtb-DNA，是一种特异度高、比较敏感、非侵入性且相对安全的儿童肺结核快速诊断方法。

Role of real-time fluorescence PCR in Mycobacterium tuberculosis complex DNA detection from stool samples of children with pulmonary tuberculosis

Objective To establish a rapid detection process of M.tuberculosis DNA in stool specimens of children using real-time fluorescence PCR and investigate its clinical diagnostic value. Methods We collected 76 stool specimens of hospitalized children with pulmonary tuberculosis and detected the M.tuberculosis DNA using real-time PCR to compare the results with the PCR results of 20 stool samples of children with other pulmonary diseases,76 stool smear results and 41 sputum samples’ smear and(or) culture,and real-time PCR results. Results The sensitivity of real-time PCR in stool samples was 23.68%(18/76),and the specificity is 100.00%(20/20).The positive rate of stool PCR(23.68%,18/76) was significantly higher than the smear test(6.58%,5/76).The number of cases tested positive from sputum smear and(or) culture(15 cases) and sputum PCR(18 cases) were larger than the number of cases tested positive from fecal PCR(11 cases). Conclusion Using real-time PCR to find TB-DNA in stool samples of children,is a highly specific,moderately sensitive,non-invasive and relatively safe method for the diagnosis of children pulmonary tuberculosis.