聚合酶链反应在诊断结核性胸膜炎中的应用

目的：应用ＰＣＲ技术对７０例胸水进行结核菌ＤＮＡ检测。方法：７０例胸水做ＴＢ－ＰＣＲ、胸水抗酸菌涂片，皮肤结素试验及血结核菌抗体检测，并与临床诊断标准进行比较。结果：７０例胸水中，结核性胸腔积液４６例，ＰＣＲ阳性率４５．７％，涂片镜检、结素强阳性、结核菌抗体（＋）则分别为２．２％，８．７％，１０．９％，前者明显高于后三者（Ｐ值均＜０．００５），但其ＰＣＲ敏感性与临床诊断标准比较相关性仍低，非结核性胸水２４例中，ＰＣＲ阳性率８．３％。结论：ＰＣＲ检测结核菌尚有一些条件需进一步完善，目前临床尚不能将其作为诊断结核病包括结核性胸膜炎的标准，仍需结合病人的临床表现及其它检查结果来综合判断。

Polymerase Chain Reaction for the Diagnosis of Tuberculous Pleural Effusion.

Polymerase Chain Reaction(PCR)was applied to detect DNA of mycobacterium tuberculosis(TB)in 70 patients with pleural effusion. Methods:These effusions were made TB-PCR,the positive rate of pleural effusion acid-fast staining,tuberculin skin test and tuberculous antibody. The Result of PCR was compared with those of conventional procedures and clinical diagnosis standard. Results:It was found that in 46 tuberculous pleural effusion, the positive rate of pleural effusion acid-fast staining,trberculin skin test,tuberculors antibody and PCR was 2.2%. 8.7%. 10.9% and 45.7% respectively.The sensitivity of PCR was much higher than the former diagnostic procedures (all P<0.005).But the sensitivity of PCR was lower than tuberculous diagnosis standard,In 24 patients with non-TB Pleural effusion, 2 patients were confirmed that TB-PCR was positive. Conclusions:up to now,PCR Could not be a useful tool for diagnosis of mycobacterium tuberculosis(include tuberculous pleural effusion.It must be perfected some conditions. Diagnosis of tuberculousis still need to be determined by the patient’clinical manfestions and others methods.