淋巴细胞部份结核分枝杆菌DNA检测的临床意义

目的 判别淋巴细胞部份 T B D N A 检测的临床意义?方法 将淋巴细胞分离液分离血细胞方法与 P C R 方法结合,对150 例活动性结核?50 例非结核?30 例结核病已于三年前治愈者?30 例健康对照者同步检测外周血淋巴细胞部份和血浆部份的 T B D N A123bp 和245bp ；并观察30 例初治肺结核病人外周血淋巴细胞部份 T B D N A 转阴时间?整个研究采取双盲法?结果 确实有 T B D N A 存在于活动性肺结核病人淋巴细胞部份而不是血浆部份?在结核病诊断中,检测123bp 的敏感性91.3 % ,特异性100 % ；检测245bp的敏感性83.3 % ,特异性92 % ?初治结核病人正规治疗后 T B D N A 大多在第9 个月转阴性,不会持续阳性?结论 淋巴细胞部份 T B D N A P C R 检测更易质量控制,更能反映结核病的活动性?

Clinical value of detection of M .tuberculosis D N Ain peripheral blood lym phocyte fraction

Objective To evaluate the clinical value of detection of M.tuberculosis( M T B) D N Ain peripheral bloodlymphocyte fraction ( P B L F)for identifying patients with active tuberculosis. Method Polymerase chain reaction( P C R)technique was used to am plify 123bp and 245bp D N Afragment of M T Bin lymphocyte fraction separated from peripheralblood and in blood plasma sim ultaneously . The duration needed for elimination of M T B D N Ain P B L Fof patients with ac tive tuberculosis was investigated . Results It was verified again that,patient with active tuberculosis have M T B_ D N Aintheir P B L F,but notin plasma . The sensitivity of detecting M T B_ D N A123bp is 91 3 % (137/150) ,and 245bp is 83 3 %(125/150) . The particularity of detecting M T B_ D N A 123bp is 100 % (50/50) ,and 245bp is 92 0 % (46/50) . In 3month before end of the treatmet course, M T B were not found in sputu m smear in any of 30 initial treated patients withactive tuberculosis ,at same time thelesion in theirlung became steady . The M T B_ D N Ain P B L Fin 4 of 30 initialtreatedpatients became negative on the 6th month oftreatment course ,in 23 of 30 ,on the 9th month ,and in 3 of 30 ,on the 12thmonth . To our surprise ,the M T B_ D N Ain 25 of the 30 patients reverted to be negative within 3 months follow up . The M T B_ D N A123bp in P B L F was negetive in all persons without active tuberculosis but with positive P P Dskin test(includ ing 10 cases who were suffering from other diseases ,30 people whose tuberculosis had been cured for three years , 11healthy persons) . Conclusion Since the presence of M T B_ D N Ain P B L Fin cured patients cannot lase for a long time ,wesuggest that P C Rassay of M T B_ D N Ain P B L Fcould be used to determine active tuberculosis and to monitor the efficacyofthe treatment of tuberculosis.