用于检测结核分枝杆菌IS6110的粪便聚合酶链反应，以区分克罗恩病与肠结核。
Fecal polymerase chain reaction for Mycobacterium tuberculosis IS6110 to distinguish Crohn's disease from intestinal tuberculosis.
作者信息
Ramadass Balamurugan, Chittaranjan Sucharita, Subramanian Venkataraman, Ramakrishna Balakrishnan S
机构信息
Department of Gastrointestinal Sciences, Christian Medical College, Vellore 632004, India.
出版信息
Indian J Gastroenterol. 2010 Jul;29(4):152-6. doi: 10.1007/s12664-010-0022-3. Epub 2010 Jun 25.
BACKGROUND
We have previously shown that amplification of Mycobacterium tuberculosis specific DNA (TB PCR) from feces reliably diagnosed intestinal tuberculosis. This study was undertaken to determine how well this test would distinguish intestinal tuberculosis from Crohn's disease in a country endemic for tuberculosis.
METHODS
Consecutive patients with diagnoses of Crohn's disease and intestinal tuberculosis were enrolled, and the diagnoses confirmed by follow up. DNA was extracted from fecal samples and subjected to polymerase chain reaction TB PCR for IS6110 sequence which is specific for M. tuberculosis.
RESULTS
Twenty one of 24 patients with intestinal tuberculosis and 5 of 44 patients with Crohn's disease tested positive by TB PCR. The sensitivity, specificity, positive predictive and negative predictive values for TB PCR in distinguishing tuberculosis from Crohn's disease were 0.79 (95% confidence interval 0.57-0.92), 0.88 (0.75-0.96), 0.79 (0.57-0.92) and 0.88 (0.75-0.96), respectively. A combination of fecal TB PCR with mycobacterial culture of mucosal biopsy specimens identified 23 of 24 (96.2%) of patients with intestinal TB, with sensitivity, specificity, positive predictive and negative predictive values (95% CI) of 0.95 (0.78-0.99), 0.88 (0.75-0.96), 0.82 (0.63-0.93) and 0.97 (0.86-0.99), respectively.
CONCLUSION
Fecal TB PCR is a good screening test to distinguish intestinal tuberculosis from Crohn's disease.
背景
我们之前已经表明，从粪便中扩增结核分枝杆菌特异性DNA（结核PCR）能够可靠地诊断肠结核。本研究旨在确定在一个结核病流行的国家中，该检测在区分肠结核和克罗恩病方面的效果如何。
方法
纳入连续诊断为克罗恩病和肠结核的患者，并通过随访确认诊断。从粪便样本中提取DNA，并进行针对结核分枝杆菌特异性的IS6110序列的聚合酶链反应结核PCR。
结果
24例肠结核患者中有21例、44例克罗恩病患者中有5例结核PCR检测呈阳性。结核PCR在区分结核病和克罗恩病方面的敏感性、特异性、阳性预测值和阴性预测值分别为0.79（95%置信区间0.57 - 0.92）、0.88（0.75 - 0.96）、0.79（0.57 - 0.92）和0.88（0.75 - 0.96）。粪便结核PCR与黏膜活检标本的分枝杆菌培养相结合，在24例肠结核患者中识别出23例（96.2%），其敏感性、特异性、阳性预测值和阴性预测值（95%CI）分别为0.95（0.78 - 0.99）、0.88（0.75 - 0.96）、0.82（0.63 - 0.93）和0.97（0.86 - 0.99）。
结论
粪便结核PCR是区分肠结核和克罗恩病的良好筛查检测方法。
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