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目的应用实时荧光PCR快速检测肺结核患儿粪便中Mtb-DNA,并初步评估其临床效果。方法收集肺结核住院儿童粪便标本76份,应用实时荧光PCR检测Mtb-DNA,检测结果与20例其他呼吸系统疾病患儿的粪便实时荧光PCR检测Mtb-DNA、76例粪便抗酸杆菌涂片检查以及41例患儿痰标本的涂片和(或)培养、实时荧光PCR检测结果进行比较。结果粪便实时荧光PCR检测敏感度达到23.68%(18/76),特异度为100.00%(20/20),肺结核患儿粪便PCR阳性率[23.68%(18/76)]明显高于涂片阳性率[6.58%(5/76)],41例患儿中痰涂片和(或)培养阳性例数(15例)和痰PCR检测阳性例数(18例)高于粪便PCR检测阳性例数(11例)。结论实时荧光PCR检测儿童粪便Mtb-DNA,是一种特异度高、比较敏感、非侵入性且相对安全的儿童肺结核快速诊断方法。
Objective To evaluate the clinical efficacy of Mtb-DNA in stool samples of pulmonary tuberculosis patients by real-time fluorescence PCR. Methods Totally 76 stool samples from hospitalized children with pulmonary tuberculosis were collected. Mtb-DNA was detected by real-time fluorescence PCR. MTT was detected by real-time stool PCR in 20 children with respiratory diseases and 76 stool samples 41 cases of sputum samples smear and (or) culture, real-time fluorescence PCR test results were compared. Results The sensitivity of fecal real-time PCR was 23.68% (18/76), the specificity was 100.00% (20/20), and the positive rate of stool PCR in children with tuberculosis [23.68% (18/76)] was significantly higher than that of smear The positive rate of sputum smear and / or culture (15 cases) and positive sputum PCR (18 cases) in sputum were higher than that of fecal samples detected by PCR (6.58%, 5/76) (11 cases). Conclusion Real-time fluorescence PCR detection of feces Mtb-DNA in children is a highly specific, sensitive, non-invasive and relatively safe method for the rapid diagnosis of pulmonary tuberculosis in children.