Lin J J, Harn H J, Hsu Y D, Tsao W L, Lee H S, Lee W H
Department of Neurology, Tri-Service General Hospital No. 8, Taipei, Taiwan.
J Neurol. 1995 Feb;242(3):147-52. doi: 10.1007/BF00936887.
A polymerase chain reaction (PCR) method for the rapid diagnosis of tuberculous meningitis (TBM) was used to study prospectively 47 cerebrospinal fluid (CSF) samples from 45 patients. Twenty CSF samples were from patients with clinically suspected TBM and another 27 samples came from patients without clinically suspected TBM. Mycobacterial DNA was detected in 15 CSF samples (14 from patients with clinically suspected TBM and 1 from a patient not suspected of having TBM). Of the PCR-positive samples, 4 were also positive for mycobacterial culture. However, 32 PCR-negative samples were all culture-negative. All samples were negative for the acid-fast bacillus by direct smear. The single PCR-positive patient in the clinically unsuspected TBM group was initially diagnosed as suffering from aseptic meningitis on the basis of his clinical features. The mycobacterial culture of his CSF specimen was also positive and a revised diagnosis of an aseptic type of TBM was made. The estimations of specificity and sensitivity in this study were 100% and 70% respectively. The results showed that using a PCR to detect mycobacterial DNA in CSF for the early diagnosis of TBM is not only a rapid but also an accurate method.
采用一种用于快速诊断结核性脑膜炎（TBM）的聚合酶链反应（PCR）方法，对45例患者的47份脑脊液（CSF）样本进行了前瞻性研究。20份CSF样本来自临床疑似TBM的患者，另外27份样本来自临床未疑似TBM的患者。在15份CSF样本中检测到分枝杆菌DNA（14份来自临床疑似TBM的患者，1份来自未疑似患有TBM的患者）。在PCR阳性样本中，4份分枝杆菌培养也呈阳性。然而，32份PCR阴性样本的培养均为阴性。所有样本直接涂片抗酸杆菌均为阴性。临床未疑似TBM组中唯一PCR阳性的患者最初根据其临床特征被诊断为无菌性脑膜炎。其CSF标本的分枝杆菌培养也呈阳性，因此修正诊断为无菌型TBM。本研究中特异性和敏感性的估计分别为100%和70%。结果表明，利用PCR检测CSF中的分枝杆菌DNA用于TBM的早期诊断不仅快速而且准确。
