PCR早期诊断结核性胸膜炎的临床价值

CLINICAL VALUE OF PCR IN EARLY DIAGNOSIS OF TUBERCULOUS PLEURISY

比较了PCR、涂片法、OT试验及胸膜活检4种方法诊断结核性胸膜炎的临床价值。结果显示：PCR法灵敏度为48％，显著高于其它诸法（P＜0．05或0．01），其特异度为91．6％，与其它诸法接近（P均＞0．05）。PCR法具有快速、灵敏、简便及不依赖结核菌培养等优点，应作为胸腔积液患者的常规检查项目。但其假阴性率、假阳性率分别达52％和8．4％，致其可信性受限。本文对产生假阴性和假阳性的原因进行了分析，并提出了减少假阴性和假阳性的方法。

The aim of this work is to investi-gate the clinical value of PCR, smear, OT test and biopsy of pleura in early diagnosis of tuberculous pleurisy. The results showed that sensitivity of PCR was 48%, which was significantly higher than other methods' (P < 0. 05 ). In addition to the above,PCR had many advantages such as quickness, con-venience and non-depending on culture of the tuber-cle bacillus. So it should be a routine laboratory test for patients with hydrothorax but there existed false negative rate of 52 % and false posltive rate of 8. 4%by using this method, which seriously reduced its reliability. The authors also analysed the reasons of false negativeness and false positiveness, and put forward some measures to attenuate them.