RAPID DIAGNOSIS OF PLEURAL TUBERCULOSIS BY POLYMERASE CHAIN-REACTION
RAPID DIAGNOSIS OF PLEURAL TUBERCULOSIS BY POLYMERASE CHAIN-REACTION
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DOI：
10.1164/ajrccm.152.6.8520765
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发表时间：
1995-12-01
影响因子：
24.7
通讯作者：
GARCIADELOMAS, J
中科院分区：
文献类型：
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作者：
QUEROL, M;MINGUEZ, J;GARCIADELOMAS, J
我们研究了聚合酶链反应（PCR）用于胸膜结核的快速诊断。该研究包括21例经培养或胸膜活检证实的胸膜结核患者和86例对照受试者。PCR检测是基于检测属于插入序列IS 6110的123-bp DNA片段，特异于结核分枝杆菌复合体。在21例诊断为胸膜结核的患者中，3例（14%）（95% CI，7 - 21%）Ziehl-Neelsen染色阳性，11例（52%）（95% CI，43 - 61%）胸水培养阳性。胸膜活检显示72%的患者有肉芽肿伴干酪样坏死，67%的患者培养阳性。腺苷脱氨酶活性测定为阳性（> 45 IU/L）的患者占86%（95% CI，79 - 93%）。PCR的敏感性和特异性分别为81%（95%CI，74 - 88%）和100%（95%CI，95 - 100%）。所有培养阳性标本均为PCR阳性。结论：PCR是一种快速、敏感、特异的诊断胸膜结核的方法。然而，需要进一步的前瞻性研究来正确评估该技术的产量。
We have investigated the use of polymerase chain reaction (PCR) for the rapid diagnosis of pleural tuberculosis. The study was composed of 21 patients with pleural tuberculosis, confirmed by culture or pleural biopsy, and 86 control subjects. The PCR assay was based on detecting a 123-bp DNA segment belonging to the insertion sequence IS6110, specific of Mycobacterium tuberculosis complex. In 21 patients diagnosed with pleural tuberculosis, Ziehl-Neelsen staining was positive in three (14%) (95% CI, 7 to 21%) and pleural fluid culture in 11 (52%) (95% CI, 43 to 61%). Pleural biopsy revealed granulomas with caseous necrosis in 72%, and the culture was positive in 67% of the patients. Adenosine deaminase activity determination was positive (> 45 IU/L) in 86% (95% CI, 79 to 93%). The sensitivity and specificity for PCR was 81% (95% CI, 74 to 88%) and 100% (95% CI, 95 to 100%), respectively. All culture-positive specimens were PCR positive. We conclude that PCR is a rapid, sensitive, and specific method for the diagnosis of pleural tuberculosis. However, further prospective studies are required to properly evaluate the yield of the technique.