尿液结核分支杆菌检测方法在泌尿系结核诊断中的应用研究

Application of methods for detecting urine Mycobacterium tuberculosis in diagnosis of urinary tuberculosis

目的采用涂片法及实时荧光定量PCR法检测尿液中的结核分支杆菌,探讨不同检测方法对泌尿系结核诊断及鉴别的应用价值。方法 141例临床确诊或可疑的泌尿系结核患者尿液标本经涂片及RT-PCR两种方法进行检测,同期选取60例非泌尿系结核患者为对照组,不同组间检测结果进行比对分析。结果经涂片、RT-PCR法检测尿液标本,51例临床确诊的泌尿系结核患者阳性率分别为7.84%(4/51)、70.59%(36/51);90例临床可疑泌尿系结核患者阳性率分别为5.56%(5/90)、36.67%(33/90);60例非泌尿系结核患者尿液标本涂片及PCR检测均为阴性,两种方法阳性检测率存在明显差异且有统计学意义(P<0.01);实时荧光定量PCR具有高的灵敏度(70.59%)和特异度(100%)。结论实时荧光定量PCR法检测尿液中TB-DNA对泌尿系结核的诊断和鉴别具有较高的临床应用价值。

Objective To investigate the clinical value of smear and real-time fluorescent quantitative PCR method in differential diag- nosis of urinary tuberculosis. Methods The urinary samples of 141 cases of clinically diagnosed or suspected urinary tuberculosis were collected and tested by smear and PCR methods. Sixty cases of non-urinary tuberculosis were chosen as control group. Results Positive rates of urine specimens were 7.84% （4/51） and 70.59% （36/51） in 51 cases of diagnosed urinary tuberculosis by smear and PCR assay respectively, and 5.56% （5/90） and 36.67% （33/90） in 90 cases of suspected urinary tuberculosis, respectively. The posi- tive rate was significantly different between two methods （P 〈 0.01 ）. Urine specimens of 60 non-TB cases were both negative by smear and PCR analysis. Real-time fluorescent quantitative PCR had higher sensitivity（70.59% ） and specificity（ 100% ）. Conclusion Real-time fluorescent quantitative PCR assay for urinary tuberculosis has higher clinical value, and it can be used as one of effective methods of TB detection and differential diagnosis of urinary tuberculosis.