聚合酶链反应法在检测煤尘肺累及的支气管组织中结核分枝杆菌的价值。

Value of the polymerase chain reaction method for detecting tuberculosis in the bronchial tissue involved by anthracosis.

作者信息

Mirsadraee Majid, Shafahie Ahmad, Reza Khakzad Mohammad, Sankian Mojtaba

机构信息

*Department of Internal Medicine, 22 Bahman Hospital, Islamic Azad University-Mashhad Branch ‡Department of Immunology and Zakaria Research Center, Medical School of Islamic Azad University-Mashhad Branch §Immunology Research Center, Buali Research Center, Mashhad University of Medical Sciences, Mashhad †Kerman University of Medical Sciences, Kerman, Iran.

出版信息

J Bronchology Interv Pulmonol. 2014 Apr;21(2):131-4. doi: 10.1097/LBR.0000000000000063.

DOI:10.1097/LBR.0000000000000063

PMID:24739686

Abstract

BACKGROUND

Anthracofibrosis is the black discoloration of the bronchial mucosa with deformity and obstruction. Association of this disease with tuberculosis (TB) was approved. The objective of this study was to find the additional benefit of assessment of TB by the polymerase chain reaction (PCR) method.

METHODS

Bronchoscopy was performed on 103 subjects (54 anthracofibrosis and 49 control subjects) who required bronchoscopy for their pulmonary problems. According to bronchoscopic findings, participants were classified to anthracofibrosis and nonanthracotic groups. They were examined for TB with traditional methods such as direct smear (Ziehl-Neelsen staining), Löwenstein-Jensen culture, and histopathology and the new method "PCR" for Mycobacterium tuberculosis genome (IS6110).

RESULTS

Age, sex, smoking, and clinical findings were not significantly different in the TB and the non-TB groups. Acid-fast bacilli could be detected by a direct smear in 12 (25%) of the anthracofibrosis subjects, and adding the results of culture and histopathology traditional tests indicated TB in 27 (31%) of the cases. Mycobacterium tuberculosis was diagnosed by PCR in 18 (33%) patients, but the difference was not significant. Detection of acid-fast bacilli in control nonanthracosis subjects was significantly lower (3, 6%), but PCR (20, 40%) and accumulation of results from all traditional methods (22, 44%) showed a nonsignificant difference.

CONCLUSIONS

The PCR method showed a result equal to traditional methods including accumulation of smear, culture, and histopathology.

摘要

背景

肺炭末沉着纤维化是支气管黏膜出现黑色色素沉着并伴有畸形和阻塞。该疾病与肺结核（TB）的关联已得到证实。本研究的目的是探究通过聚合酶链反应（PCR）方法评估肺结核的额外益处。

方法

对103名因肺部问题需要进行支气管镜检查的受试者（54例肺炭末沉着纤维化患者和49例对照受试者）进行了支气管镜检查。根据支气管镜检查结果，将参与者分为肺炭末沉着纤维化组和非炭末沉着组。采用传统方法如直接涂片（萋 - 尼氏染色）、罗氏培养基培养和组织病理学以及针对结核分枝杆菌基因组（IS6110）的新方法“PCR”对他们进行肺结核检查。

结果

肺结核组和非肺结核组在年龄、性别、吸烟情况及临床表现方面无显著差异。在54例肺炭末沉着纤维化受试者中，12例（25%）通过直接涂片检测到抗酸杆菌，加上培养和组织病理学传统检测结果，27例（31%）被诊断为肺结核。通过PCR诊断出18例（33%）结核分枝杆菌感染患者，但差异无统计学意义。对照的非炭末沉着受试者中抗酸杆菌的检测率显著较低（3例，6%），但PCR检测率（20例，40%）以及所有传统方法检测结果的汇总率（22例，44%）显示差异无统计学意义。