多重聚合酶链反应在结核性脑膜炎诊断中的作用
Role of multiplex polymerase chain reaction in diagnosing tubercular meningitis.
作者信息
Berwal Anupam, Chawla Kiran, Vishwanath Shashidhar, Shenoy Vishnu Prasad
机构信息
Department of Microbiology, Kasturba Medical College, Manipal University, Manipal, Karnataka, India.
出版信息
J Lab Physicians. 2017 Apr-Jun;9(2):145-147. doi: 10.4103/0974-2727.199633.
Tuberculous meningitis (TBM) is one of the most serious manifestations of extrapulmonary tuberculosis. Timely and accurate diagnosis provides a favorable prognosis in patients with TBM. The study evaluated the use of multiplex polymerase chain reaction (PCR) in the diagnosis of TBM. A study was conducted on 74 patients clinically suspected with TBM. The cerebrospinal fluid (CSF) specimens were processed for smear microscopy, middle brook 7H9 culture, and multiplex PCR using primers directed against IS6110 gene and 38 kD protein for detection of Mycobacterium tuberculosis. The results were analyzed to assess the role of multiplex PCR in the diagnosis of TBM. A total of 26 (35.1%) patients were diagnosed with TBM. Microscopy was negative in all while culture was positive in two cases only. Comparing with clinical diagnosis and CSF adenosine deaminase levels of ≥10 U/L, multiplex PCR showed sensitivity, specificity, positive predictive value, and negative predictive value of 71.4%, 89.6%, 83.3%, and 81.2%, respectively, in the diagnosis of TBM.
结核性脑膜炎（TBM）是肺外结核病最严重的表现之一。及时准确的诊断可为TBM患者带来良好的预后。本研究评估了多重聚合酶链反应（PCR）在TBM诊断中的应用。对74例临床疑似TBM的患者进行了一项研究。对脑脊液（CSF）标本进行涂片显微镜检查、Middlebrook 7H9培养以及使用针对IS6110基因和38 kD蛋白的引物进行多重PCR，以检测结核分枝杆菌。对结果进行分析，以评估多重PCR在TBM诊断中的作用。共有26例（35.1%）患者被诊断为TBM。所有患者的显微镜检查均为阴性，仅2例培养结果为阳性。与临床诊断及脑脊液腺苷脱氨酶水平≥10 U/L相比，多重PCR在TBM诊断中的敏感性、特异性、阳性预测值和阴性预测值分别为71.4%、89.6%、83.3%和81.2%。
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