Nakajima H, Hatamura T, Ikemoto T, Ueda K, Nakagawa T, Shimizu A
1st Internal Medicine, Osaka Medical College, School of Medicine, Takatsuki.
Rinsho Byori. 1995 Aug;43(8):843-6.
Since Shankar et al used polymerase chain reaction (PCR) for detection of Mycobacterium tuberculosis (M. tuberculosis) in cerebrospinal fluid (CSF), there have been numerous reports on PCR assay for diagnosis of tuberculosis meningitis (TBM). The PCR assay have been recognized to be a rapid method for diagnosis of TBM, however there are problems of PCR sensitivity when dealing with CSF samples containing small amount of M. tuberculosis DNA. Comparing direct PCR with nested PCR, we studied on the evaluation of PCR for diagnosis of TBM. In present study the nested PCR were positive in all CSF specimens from 4 patients with TBM, but we could not detect M. tuberculosis DNA by only the direct PCR. Because nested PCR amplification improved the sensitivity and specificity, the nested PCR assay will be necessary for rapid diagnosis of TBM on the clinical laboratory.
自从尚卡尔等人使用聚合酶链反应（PCR）检测脑脊液（CSF）中的结核分枝杆菌（M. tuberculosis）以来，关于PCR检测法诊断结核性脑膜炎（TBM）的报道众多。PCR检测法已被公认为是诊断TBM的一种快速方法，然而在处理含有少量结核分枝杆菌DNA的脑脊液样本时，存在PCR敏感性的问题。通过比较直接PCR和巢式PCR，我们研究了PCR在TBM诊断中的评估。在本研究中，4例TBM患者的所有脑脊液标本中巢式PCR均为阳性，但仅通过直接PCR我们无法检测到结核分枝杆菌DNA。由于巢式PCR扩增提高了敏感性和特异性，巢式PCR检测法对于临床实验室快速诊断TBM将是必要的。
