荧光定量PCR技术检测结核杆菌临床应用分析

Analysis on the Clinical Application of Fluorescence Quantitative PCR Assay in Detection of Mycobacterium Tuberculosis

目的探讨荧光定量PCR技术在检测结核杆菌的临床应用价值。方法将本院临床诊断确诊为肺结核的68例患者为研究对象,采用荧光PCR技术测定两组痰液及外周血中的结核杆菌,以临床诊断结果为金标准,采用χ2检验对结果进行分析比较。结果 68例结核病患者中痰涂片、痰定量PCR、外周血定量PCR检测的阳性率为14.7%、41.2%、44.1%,定量PCR检测的阳性率显著高于痰涂片(P<0.05)。痰涂片阴性的58例患者中痰及外周血定量PCR检测阳性率为31.0%、41.3%。痰及外周血定量PCR配对检测两种标本同时检测的符合率为44.1%。结论荧光PCR技术检测结核杆菌的效果要显著优于传统涂片,其可证实、鉴定涂片阳性结果,同时对痰和外周血进行定量PCR检测,可增强互补作用,提高检测的准确率。

Objective To investigate the clinical application value of fluorescence quantitative PCR （FQ-PCR） technigue in the detection of mycobacterium tuberculosis. Methods Sixty - eight patients clinically diagnosed as pulmonary tuberculasis in the First Hospital of Baoding, Hebei Province, were chosen as the research objects. Mycobacteriurn tuberculosis in peripheral blood and one portion of sputum was determined by FQ- PCR. Another portion of sputum was subject to sputum smear. Clinical diagnosis was used as the gold standard. The results were analyzed by ;（2 test. Results The positive rate of mycobacterium tuberculosis detected by sputum smear, sputum FQ- PCR and peripheral blood FQ- PCR in 68 patients with pulmonary tuber- culosis was 14.7%, 41.2% and 44.1%, respectively. The positive rates by FQ- PCR were significantly higher than that by sputum smear （P（0.05）. The positive rates by sputum FQ- PCR and peripheral blood FQ- PCR in 58 cases with negative de- tection results by sputum smear was 31.0% and 41.3%. The coincidence rate by FQ-PCR in sputum and in paired peripheral blood was 44.1%. Conclusions Fluorescence quantitative PCR assay is superior to conventional sputum smear in mycobacte riurn tuber culosis detection. It can confirm and identify the positive results of sputum smear. To simultaneously conduct FQ PCR assay in sputum and peripheral blood can have complementary effect and improve the detection accuracy.