Hayashi M, Nagai A, Kobayashi K, Sawai T, Konno K
First Department of Medicine, Tokyo Women's Medical College, Japan.
Nihon Kyobu Shikkan Gakkai Zasshi. 1994 Jan;32(1):90-4.
A 38-year-old man was admitted to hospital because of chest pain and for the evaluation of a right pleural effusion on his chest X-ray film. Pleural effusion was characterized as exudative lymphocyte-predominant fluid with elevation of adenosine deaminase (ADA). Bacteriologic examination of pleural fluid was negative in both smear and culture of the fluid. PPD was positive and ESR was elevated. Mycobacterial DNA was detected in the pleural effusion using polymerase chain reaction (PCR) with primers which amplified a fragment of Is6110. Following treatment (INH, RFP and EB), the right pleural effusion disappeared. We conclude that PCR technique may be very useful in the rapid diagnosis of tuberculous pleurisy.
一名38岁男性因胸痛入院，并因胸部X线片显示右侧胸腔积液而接受评估。胸腔积液的特征为渗出液，以淋巴细胞为主，腺苷脱氨酶（ADA）升高。胸腔积液的细菌学检查在涂片和培养中均为阴性。结核菌素试验（PPD）呈阳性，红细胞沉降率（ESR）升高。使用扩增Is6110片段的引物，通过聚合酶链反应（PCR）在胸腔积液中检测到结核分枝杆菌DNA。经过治疗（异烟肼、利福平及乙胺丁醇），右侧胸腔积液消失。我们得出结论，PCR技术在结核性胸膜炎的快速诊断中可能非常有用。
