荧光定量PCR和抗酸染色在联合诊断结核病及其疗效考核中的应用

Application of fluorescence quantitative PCR combination with acid-fast staining in diagnosis and evaluation of their therapeutic efficacies in treating tuberculosis

目的探讨荧光定量PCR法和抗酸染色检测技术在结核病联合诊断中的价值。方法对89例临床确诊的结核病患者和22例非结核呼吸系统疾病患者的痰标本同时应用荧光定量PCR法和痰涂片抗酸染色法检测结核杆菌,并检测外周血血清结核抗体,对3种检测方法的结果进行分析比较。结果治疗前后荧光定量PCR阳性率为60.67%、25.84%,涂片抗酸染色法阳性率为23.60%、6.74%,结核抗体阳性率为71.91%和86.51%。痰标本的荧光定量PCR法阳性率均要高于抗酸染色法阳性率,比较差异有统计学意义(P<0.01)。结论荧光定量PCR技术对肺结核诊断方面灵敏度和特异性较高,同时反映抗结核治疗过程中痰标本中结核杆菌数量的变化,不仅提高了结核菌检出的阳性率,同时对抗结核药物有一定的疗效考核效果。

Objective Explore the diagnostic and therapeutic efficacy in treating tuberculosis by using fluorescence quantitative PCR combining with acid-fast staining method.Methods The specimens of sputum from 89 tuberculosis patients and 22 patients with non-tuberculosis respiratory system disease,were examined for mycobacterium tuberculosis by using acid-fast stain,fluorescence quantitative PCR and the serum tuberculosis antibody respectively. Finally we analyze and compare the results of the three methods.Results The positivity rates of fluorescence quantitative PCR before and after treatment are 60.67% and 25.84%,the positivity rates of acid-fast stain before and after treatment are 23.60% and 6.74%,and the positivity rates of the serum tuberculosis antibody before and after treatment are 71.91% and 86.51%. The positivity rate of Mycobacterium tuberculosis detected by FQ-PCR was higher than acid-fast Stain method.Conclusion Fluorescence quantitative PCR shows higher specificity and sensitivity than smear acid-fast stain. Moreover,it can also reflect the number of mycobacterium tuberculosis during the process of treatment. It is a useful tool for improving the positivity rate and assession the therapeutic efficacy of tuberculosis.