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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胸膜炎诊断中的价值。方法对362例临床确诊的结核性胸膜炎患者、可疑结核性胸膜炎患者和非结核性胸膜炎患者的胸水标本采用涂片、实时荧光定量PCR两种方法进行检测,对其结果进行对比分析。结果 362例胸水标本中,涂片阳性率为4.42%(16/362),PCR检测阳性率为24.31%(88/362)。胸水涂片、PCR检测102例临床确诊的结核性胸膜炎患者胸水标本阳性率分别为11.76%(12/102)和50.98(52/102);检测160例临床可疑结核性胸膜炎患者胸水阳性率分别为2.50%(4/160)和22.50%(36/160)。两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)。100例非结核性胸膜炎患者胸水标本涂片及PCR检测均为阴性。结论荧光定量-聚合酶链反应(FQ-PCR)快速诊断结核性胸膜炎与涂片法相比较具有快速、灵敏、高特异性等优点。
Objective To investigate the value of real-time fluorescence quantitative polymerase chain reaction (PCR) in the detection of Mycobacterium tuberculosis in the diagnosis of tuberculous pleurisy. Methods 362 clinically diagnosed tuberculous pleurisy patients, patients with suspected tuberculous pleurisy and patients with non-tuberculous pleurisy were examined by smear and real-time fluorescence quantitative PCR, and the results were compared. Results 362 cases of pleural effusion specimens smear positive rate was 4.42% (16/362), PCR test positive rate was 24.31% (88/362). The positive rate of pleural effusion in 102 clinically diagnosed tuberculous pleurisy patients was 11.76% (12/102) and 50.98 (52/102) respectively by PCR. The positive rate of pleural effusion in 160 cases of clinically suspected tuberculous pleurisy were 2.50% (4/160) and 22.50% (36/160). The positive detection rate of the two methods was statistically significant difference (χ2 = 10.654, P <0.05). 100 cases of non-tuberculous pleurisy pleural effusion smear and PCR tests were negative. Conclusion Fluorescent quantitative polymerase chain reaction (FQ-PCR) rapid diagnosis of tuberculous pleurisy compared with the smear method has the advantages of fast, sensitive and high specificity.