核酸体外扩增技术诊断骨结核的临床研究

Clinical study of polymerase chain reacftion technique in the diagnosis of bone tuberculosis

目的探讨核酸体外扩增（ＰＣＲ）技术在骨结核诊断中的价值。方法对６０例骨结核标本与２０例非骨结核标本分别应用ＰＣＲ、抗酸染色镜检及分离培养法进行结核分支杆菌检测。同时，分析了影响ＰＣＲ结果的有关因素与相应处理措施。结果６０例骨结核标本中三种方法的阳性检出率分别为：ＰＣＲ法８３％，镜检法３％，培养法７％。经统计学处理，Ｐ＜０．００５，ＰＣＲ法与镜检及培养法对结核分支杆菌的阳性检出率比较具有显著性差异，ＰＣＲ法明显优于镜检及培养法。２０例非骨结核标本镜检及培养法均阴性，ＰＣＲ法阳性率１０％。盲法结核分支杆菌和对照菌ＰＣＲ检测结果表明，ＰＣＲ的特异性为１００％。ＰＣＲ扩增整个过程自动化控制，可在数小时内完成。结论ＰＣＲ技术是一种快速、敏感、特异与简便的骨结核标本结核分支杆菌检测方法，对骨结核的诊断与鉴别诊断具有重要价值。

Objective To evaluate the clinical value of polymerase chain reaction(PCR)technique in diagnosis of bone tuberculosisMethods PCR,standard light microscopy and standard culture technique were used to detect Mycobacterium tuberculosis in samples obtained from60patients with bone tuberculosis and 20 patients without bone tuberculosis.In the meantime,some factors affecting PCR result were analysed and methods to deal with them were discussed.Results In the group of 60 patients with bone tuberculosis,the positive rate was 83% in PCR technique,3% in standard light microscope technique and 7% in the standard culture technique.Astatistically obvious difference was seen(P<0.005).In the group of 20 patients without bone tuberculosis,2 cases showed positive in PCR technique,none in the other methods.Specificity of PCR technique in ablind comparison study indicated 100%.The whole process of PCR amplification is fully automatic and can be finished within several hours,and the detection time is considerably reduced.Concluseons PCR technique is arapid、specific、sensitive and simple method for detection of mycobacterium tuberculosis in sample of bone tuberculosis,and it is of great value in the diagnosis of bone tuberculosis and differentiating bone tuberculosis from other bone diseases.