多重聚合酶链反应是否能提高骨关节结核的诊断率？80 例前瞻性评估。
Does multiplex polymerase chain reaction increase the diagnostic percentage in osteoarticular tuberculosis? A prospective evaluation of 80 cases.
机构信息
Department of Medical Microbiology, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
出版信息
Int Orthop. 2012 Feb;36(2):255-9. doi: 10.1007/s00264-011-1241-7. Epub 2011 Mar 26.
Abstract
PURPOSE
Multiplex Polymerase Chain Reaction (MPCR) is a technique in which two or more gene targets are amplified in a single reaction. This has increased sensitivity of diagnosis as a single gene target may be absent in some Mycobacterium tuberculosis strains.
METHODS
MPCR using two target genes specific for Mycobacterium tuberculosis, that is, IS6110 and MPB 64, ZN staining and Mycobacterial culture were performed on synovial fluid/pus samples of 80 (three confirmed, 77 suspected) patients of osteoarticular tuberculosis and 25 non tuberculosis patients.
RESULTS
MPCR had a sensitivity of 100% in confirmed cases and 81.8% in clinically suspected cases. AFB was positive in one patient and Mycobacterial culture was positive in three patients. MPCR also had 100% specificity; MPB64 was positive in five patients in which IS6110 was negative whereas IS6110 was positive in two patients in which MPB64 was negative.
CONCLUSIONS
MPCR is a sensitive and specific method for diagnosis of paucibacilliary conditions such as osteoarticular tuberculosis.
摘要
目的
多重聚合酶链反应（MPCR）是一种在单个反应中扩增两个或多个基因靶标的技术。这提高了诊断的灵敏度，因为某些结核分枝杆菌菌株可能不存在单个基因靶标。
方法
对 80 例（3 例确诊，77 例疑似）骨关节结核患者和 25 例非结核患者的滑膜/脓液样本进行了两种针对结核分枝杆菌的特定靶基因 IS6110 和 MPB64 的 MPCR、ZN 染色和分枝杆菌培养。
结果
在确诊病例中，MPCR 的灵敏度为 100%，在临床疑似病例中为 81.8%。一名患者的 AFB 阳性，三名患者的分枝杆菌培养阳性。MPCR 也具有 100%的特异性；在 5 例 MPB64 阳性而 IS6110 阴性的患者中，2 例 IS6110 阳性而 MPB64 阴性的患者中。
结论
MPCR 是一种敏感且特异的方法，可用于诊断少菌条件，如骨关节结核。
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