慢性肾衰患者并发结核病的诊断结核菌DNA-PCR与抗PPD-IgG的比较

^^Diagnosis of CRF Patients Comlicatedwith Tuberculosis ComprisionTB Bacillus DNA--PCR with Anti-PPD--IgG

慢性肾衰患者的结核病发生率高，肺外结核多见，缺乏特异的临床表现，故诊断较为困难。本研究检测了１１例慢性肾衰并发结核患者的血中结核菌ＤＮＡ－ＰＣＲ和血清抗ＰＰＤ～ＩｇＧ（ＥＬＩＳＡ），并检测了其中５例患者的渗出液（肺、腹水）及排泄物（尿，痰），结果表明，在血中，抗ＰＰＤ－ＩｇＧ的阳性率明显高于结核菌ＤＮＡ－ＰＣＲ，在渗出液或排泄物中，二者的阳性率大致相同．提示在尿毒症患者这一特定的人群中，血清或渗出液（排泄物）中抗ＰＰＤ－ＩｇＧ的检测对诊断结核有重要意义。

The incidence of tuberculosis (TB) in patients with chronic renalfailure (CRF) is 10-16 time as high as that prevailing in the general communityand the diagnosis is often obscured because of its nonspecific symptoms. in 11 casesof CRF patients complicated with tuberculosis,serum anti-purifed protein derivativeIgG (Anti-PPD-IgG) and TB bacillus DNA-PCR were measured,and in five of the11 patients these were also measured in secritions (excretions). The result showedthat in blood the positive rate of Anti--PPD-IgG were much higher than that of TBbacillus DNA,but in secretions (excretions )the positive rates of two methods hadno statistical difference. The above results may indicate that for some specific population such as CRF patients,the assessment of Anti-PPD-IgG level is valuable in thediagnosis of TB.