聚合酶链反应及其与结核性葡萄膜炎的临床特征和治疗反应的相关性。
Polymerase Chain Reaction and its Correlation with Clinical Features and Treatment Response in Tubercular Uveitis.
机构信息
a Department of Uveitis , Aravind Eye Hospital , Madurai , India.
b Department of Ocular Microbiology , Aravind Medical Research Foundation , Madurai , India.
出版信息
Ocul Immunol Inflamm. 2018;26(6):845-852. doi: 10.1080/09273948.2017.1287925. Epub 2017 Jun 30.
PURPOSE
Correlation of results of polymerase chain reaction for Mycobacterium tuberculosis (MTB PCR) with clinical features and treatment response in tubercular uveitis.
METHODS
Retrospective case study.
RESULTS
Among 56 patients, 31 (55.3%) had acute and 25 (44.6%) had chronic uveitis. Uveitis was unilateral in 40 (71.4%) and bilateral in the remaining 16 (28.6%). Anatomical subtypes of uveitis were: anterior in 10 (13.9%) eyes, intermediate in 9 (12.5%), posterior in 17 (23.6%), and pan uveitis in 36 (50%) eyes. MTB PCR was positive in 24 patients. There was an 80% correlation between clinical response to antitubercular therapy (ATT) and PCR results. Twenty-two patients with positive PCR had a good clinical response. The sensitivity and specificity was 73.3% and 92.3%, respectively.
CONCLUSIONS
The diagnosis of intraocular TB requires strong clinical suspicion with corroborative laboratory and radiological evidence. A positive PCR is reliable whereas negative results should be correlated with clinical features. An adequate response to ATT supports PCR results.
目的
探讨结核分枝杆菌聚合酶链反应（MTB-PCR）结果与结核性葡萄膜炎的临床特征和治疗反应的相关性。
方法
回顾性病例研究。
结果
56 例患者中，31 例（55.3%）为急性葡萄膜炎，25 例（44.6%）为慢性葡萄膜炎。葡萄膜炎单侧 40 例（71.4%），双侧 16 例（28.6%）。葡萄膜炎的解剖亚型为：前部 10 眼（13.9%），中间部 9 眼（12.5%），后部 17 眼（23.6%），全葡萄膜炎 36 眼（50%）。24 例患者 MTB-PCR 阳性。抗结核治疗（ATT）临床反应与 PCR 结果有 80%的相关性。22 例 PCR 阳性患者临床反应良好。敏感性和特异性分别为 73.3%和 92.3%。
结论
眼内 TB 的诊断需要强烈的临床怀疑，并辅以实验室和影像学证据。阳性 PCR 是可靠的，而阴性结果应与临床特征相关。对 ATT 的充分反应支持 PCR 结果。
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