结核分枝杆菌DNA及RNA检测在结核病中的诊断价值

Diagnostic value of DNA and RNA detection of MTB in tuberculosis

目的分析结核分枝杆菌DNA和RNA联合检测在结核病诊断中的意义。方法对1168例用实时荧光定量PCR法检测结核菌DNA为阳性的标本继续用恒温扩增技术检测结核菌RNA。结果1168例研究对象中,DNA检测阳性601例,阳性率51.46%;其中男性377例,阳性率49.22%,女性224例,阳性率55.72%;RNA检测阳性297例,阳性率25.43%;其中男性188例,阳性率29.06%,女性109例,阳性率20.92%。不同性别的DNA和RNA检测阳性率差异有统计学意义(χ^(2)=4.466、10.07,P<0.05)。各类标本中痰液DNA和RNA及DNA+RNA检测阳性最高,分别为335例、170例、142例,阳性率分别为55.74%、57.24%、60.43%,脑脊液DNA和RNA及DNA+RNA检测阳性最低。不同年龄组中,21~30岁组DNA检测阳性最高,为133例,阳性率22.13%。41~50岁组RNA及DNA+RNA检测阳性最高,分别为67例、62例,阳性率分别为22.56%、25.96%;10≤岁组DNA和RNA及DNA+RNA检测阳性最低。结论MTB-DNA检测阳性率明显高于MTB-RNA且女性较男性高;各种检测在不同类型标本中,痰液阳性率最高,脑脊液最低;年龄组在21~30岁组DNA阳性率最高,41~50岁组RNA及DNA+RNA阳性率最高,10≤岁组各检测阳性率最低。

Objective To analyze the significance of combined detection of mycobacterium tuberculosis DNA and RNA in the diagnosis of pulmonary tuberculosis.Methods In 1168 cases of TB DNA positive samples detected by real-time fluorescent quantitative PCR,TB RNA was detected by constant temperature amplification.Results Among the 1168 study subjects,601 cases were found to be DNA positive,with a positive rate of 51.46%;There were 377 men(49.22%),224 women(55.72%);RNA test was positive in 297 cases,the positive rate of 25.43%;There were 188 males(29.06%),and 109 women(20.92%).There was statistically significant differences in the positive rates of DNA and RNA detection in different genders(χ^(2)=4.466,10.07,P<0.05).The sputum DNA and RNA and DNA+RNA had the highest positive in all kinds of specimens,with 335,170,and 142 cases,and the positive rates were 55.74%,57.24%,and 60.43%,respectively,cerebrospinal fluid DNA,RNA and DNA+RNA test were the least positive.Among different age groups,the 21-30 years old group had the highest DNA test positive,with 133 cases(22.13%).The 41-50 years old group had the highest RNA and DNA+RNA test positives,with 67 cases and 62 cases,with the positive rates of 22.56%and 25.96%,respectively;≤10 years old group had the lowest DNA,RNA,and DNA+RNA test positives.Conclusions The positive rate of MTB-DNA detection is significantly higher than that of MTB-RNA,and higher in women than that in men.Among different types of specimens,the positive rate of sputum is the highest,and the cerebrospinal fluid is the lowest In the age group,the 21-30 years old group had the highest positive rate of DNA,the 41-50 years old group had the highest positive rate of RNA and DNA+RNA,and the≤10 years old group had the lowest positive rate of each test.