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我们检测30例老年人结核性胸腔积液患者胸水PCR—TB—DNA以探讨PCR技术对老年人结核性渗出性胸膜炎的诊断价值,以24例老年人癌性胸腔积液作为对照。30例结核性胸腔积液中2例(6.7％)胸水涂片抗酸杆菌阳性,4例(13.3％)胸膜活检示结核特征性病理改变,26例(86.7％)胸水ADA>45U/L,14例(46.7％)胸水PCR—TB—DNA阳性,与施焕中等的52.9％相似,但均明显低于Maartens报道的敏感性81％。24例癌性胸腔积液中6例(25％)胸水PCR—TB—DNA阳性。提示检测胸水PCR—TB—DNA应严格操作规程,减少假阳性及假阴性,以提高其诊断结核性渗出性胸膜炎的实用价值。
We detected PCR-TB-DNA of pleural effusion in 30 elderly patients with tuberculous pleural effusion to investigate the diagnostic value of PCR for tuberculous exudative pleurisy in the elderly. 24 elderly patients with cancerous pleural effusion were used as controls. Pleural biopsy showed characteristic histopathological changes of tuberculosis in 2 pleural effusions (6.7%), pleural fluid biopsy in 4 cases (13.3%), ADA> 45 U / L in 26 pleural effusions (6.7% PCR-TB-DNA was positive in 14 cases (46.7%) of pleural effusions, which was similar to 52.9% in Shihuanzhong medium, but both were significantly lower than the reported 81% sensitivity of Maartens. Six of 24 (25%) pleural effusions in 24 cancerous pleural effusions were positive for PCR-TB-DNA. Tip detection of pleural fluid PCR-TB-DNA should be strictly operating procedures to reduce false-positive and false-negative, in order to improve its diagnostic value of tuberculous exudative pleurisy.