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分子、微生物学和免疫学检测在骨与关节结核诊断中的应用。

Application of molecular, microbiological, and immunological tests for the diagnosis of bone and joint tuberculosis.

作者信息

Tang Yinghua, Yin Lianli, Tang Shifu, Zhang Hongyu, Lan Jihui

机构信息

Department of Clinical Laboratory, Liuzhou traditional Chinese Medical Hospital, the Third Affiliated Hospital of Guangxi University of traditional Chinese Medicine, Liuzhou, Guangxi, China.

Department of Laboratory Science, Guangxi Tuberculosis Prevention and Treatment Center, the Longtan Hospital of Guangxi Zhuang Autonomous Region, Liuzhou, Guangxi, China.

出版信息

J Clin Lab Anal. 2018 Feb;32(2). doi: 10.1002/jcla.22260. Epub 2017 May 22.

Abstract

BACKGROUND

To evaluate the application of interferon gamma release assay (IGRA), rifampicin resistant real-time fluorescence quantitative PCR technique Xpert Mycobacterium tuberculosis/rifampicin (Xpert MTB/RIF), and the levels of TNF-α and TGF-β in the diagnosis of bone and joint tuberculosis.

METHODS

Eighty-six patients with bone and joint tuberculosis, diagnosed by pathology or microbiology, were examined by Xpert MTB/RIF and IGRA (T-SPOT. TB) for Mycobacterium tuberculosis infection, and the TNF-α and TGF-β levels of the patients were measured.

RESULTS

The sensitivity of IGRA in diagnosing bone and joint tuberculosis was 81.4%; Xpert MTB/RIF's sensitivity was 70.9%. The combined sensitivity of the two methods was 91.9%. The combined detection sensitivity of the two methods was higher than individual IGRA or Xpert MTB/RIF detection sensitivity. The TNF-α and TGF-β levels in bone and joint tuberculosis patients were higher than those in the control group.

CONCLUSION

Xpert MTB/RIF, IGRA, TNF-α, and TGF-βs expression have value in the rapid diagnosis of bone and joint tuberculosis, and the sensitivity and accuracy of bone and joint tuberculosis diagnosis by combining them can improve it.

摘要

背景

评估γ-干扰素释放试验(IGRA)、利福平耐药实时荧光定量PCR技术Xpert结核分枝杆菌/利福平(Xpert MTB/RIF)以及肿瘤坏死因子-α(TNF-α)和转化生长因子-β(TGF-β)水平在骨与关节结核诊断中的应用。

方法

选取86例经病理或微生物学确诊的骨与关节结核患者,采用Xpert MTB/RIF和IGRA(T-SPOT.TB)检测结核分枝杆菌感染情况,并检测患者的TNF-α和TGF-β水平。

结果

IGRA诊断骨与关节结核的灵敏度为81.4%;Xpert MTB/RIF的灵敏度为70.9%。两种方法的联合灵敏度为91.9%。两种方法联合检测的灵敏度高于单独的IGRA或Xpert MTB/RIF检测灵敏度。骨与关节结核患者的TNF-α和TGF-β水平高于对照组。

结论

Xpert MTB/RIF、IGRA、TNF-α和TGF-β的表达在骨与关节结核的快速诊断中具有价值,联合应用可提高骨与关节结核诊断的灵敏度和准确性。

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