结核分枝杆菌L型及其巨球体诊断价值的研究.pdfVIP

2174 中国卫生检验杂志2007年l2月第l7卷第l2期 Chinese Journal of Health Laboratory Technology，Dec 2007；Vol 17 No 12 【论著】 结核分枝杆菌L型及其巨球体诊断价值的研究 朱明利 (杭州市第六人民医院浙江中医药大学附属杭州第六医院开放实验室，杭州 310014) [摘要】 目的：研究结核分枝杆菌L型及其巨球体在肺结核细菌学诊断上的价值。方法：以非结核患者痰标本作为对 照，观察52例菌阴肺结核患者痰培养前后结核分枝杆菌L型及其巨球体的镜下形态和阳性率，并采用免疫组化染色和 荧光定量PCR技术(FQ—PCR)对其进行鉴定。部分标本透射电镜观察。结果：患者痰有60％(31／52)检出结核分枝杆 菌L型。结核菌L型阳性者中L型巨球体阳性率为55％(17／31)，而对照组均阴性。结核菌L型巨球体者免疫组化染色 均阳性，FQ—PCR检测阳性率71％(12／17)，透射电镜发现缺壁结核菌。结论：结核分枝杆菌L型检测可提高肺结核患 者细菌学诊断阳性率；巨球体是分枝杆菌L型重要的存在形式，可作为线索用于菌阴肺结核的辅助诊断。 【关键词】 分枝杆菌；结核；巨球体；L型 [中图分类号】 R378．91 [文献标识码】 A [文章编号】 1004—8685(2007)12—2174—03 Diagnostic value of L——forms and large bodies of mycobacterium tuberculosis in patients with pulmonary tuberculosis Zhu胁 一li (Hangzhou Sixth People S Hospital，Hangzhou 3 10014，China) [Abstract] Objective：To study the microbiological characteristics and diagnostic values of L—forms and L—bodies(also named large spheres)of myeobaeterium tuberculosis(Mth)in patients with pulmonary tuberculosis．Methods：L—forms or L— bodies of Mtb before and after sputum cultivation were detected by microscopy，immunohistochemistry(IHC)and fluorescence quantitive polymerase chain reaction(FQ—PCR)．Part of the samples were re—confirmed’by transmission electron microscopy (TEM)．Results：L—forms of Mth was revealed from 60％ (31／52)cases of patients with pulmonary tuberculosis．The positive rate of L—body was 55％(17／31)in the sputum ofpatients infected witIl L—forms of Mth．and 0％for controls．Moreover，IHC of samples containing large sphere were all positive，the positive rate of FQ—PCR Was 71％(12／17)，and the cell wall—deft— cient bacteria were observed by TEM．Conclusion：Detecting the L—forms of Mycobacterium tuberculosis increased the number of positive results in patients with sputum negative pulmonary tub