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结核分枝杆菌L型及其巨球体诊断价值的研究 被引量:2

Diagnostic value of L-forms and large bodies of mycobacterium tuberculosis in patients with pulmonary tuberculosis
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摘要 目的:研究结核分枝杆菌L型及其巨球体在肺结核细菌学诊断上的价值。方法:以非结核患者痰标本作为对照,观察52例菌阴肺结核患者痰培养前后结核分枝杆菌L型及其巨球体的镜下形态和阳性率,并采用免疫组化染色和荧光定量PCR技术(FQ-PCR)对其进行鉴定。部分标本透射电镜观察。结果:患者痰有60%(31/52)检出结核分枝杆菌L型。结核菌L型阳性者中L型巨球体阳性率为55%(17/31),而对照组均阴性。结核菌L型巨球体者免疫组化染色均阳性,FQ-PCR检测阳性率71%(12/17),透射电镜发现缺壁结核菌。结论:结核分枝杆菌L型检测可提高肺结核患者细菌学诊断阳性率;巨球体是分枝杆菌L型重要的存在形式,可作为线索用于菌阴肺结核的辅助诊断。 Objective:To study the microbiological characteristics and diagnostic values of L-forms and L-bodies ( also named large spheres) of mycobacterium tuberculosis(Mth) in patients with pulmonary tuberculosis. Methods: L-forms or L-bodies of Mtb before and after sputum cultivation were detected by microscopy, immunohistochemistry (IHC) and fluorescence quantitive polymerase chain reaction(FQ-PCR). Part of the samples were re-confirmed ' by transmission electron microscopy (TEM). Results:L-forms of Mth was revealed from 60% (31/52) cases of patients with pulmonary tuberculosis. The positive rate of L - body was 55% ( 17/31 ) in the sputum of patients infected with L-forms of Mth, and 0% for controls. Moreover, IHC of samples containing large sphere were all positive, the positive rate of FQ-PCR was 71% (12/17), and the cell wall-deficient bacteria were observed by TEM. Conclusion: Detecting the L-forms of Mycobacterium tuberculosis increased the number of positive results in patients with sputum negative pulmonary tuberculosis. L-bodies exist in patients with pulmonary tuberculosis , and they may be clue cells for tuberculosis diagnosis in patients with Mtb L-forms infection.
作者 朱明利
出处 《中国卫生检验杂志》 CAS 2007年第12期2174-2176,共3页 Chinese Journal of Health Laboratory Technology
基金 杭州市医药卫生科技计划项目(2003B041)
关键词 分枝杆菌 结核 巨球体 L型 Mycobacterium tuberculosis(Mtb) L-body(or large sphere) L-forms
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