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[目的]评估活动性关节结核不同病理材料聚合酶链式反应(polymerase chain reaction,PCR)检测结果,探索提高PCR检测阳性率的方法。[方法]2013年1月~2014年12月,对43例晚期活动性关节结核患者手术中获取脓液、干酪样组织及肉芽组织分别进行结核分枝杆菌(MTB)荧光定量PCR检测。男23例,女20例;年龄15~74岁,平均45.6岁。其中膝关节结核20例,髋关节结核15例,肩关节结核3例,踝关节结核3例,距下关节结核1例,骶髂关节结核1例。对3种不同病理材料PCR检测阳性率进行比较分析。[结果]肉芽组织74.42%(32/43)阳性率明显高于干酪样组织58.14%(25/43)和脓液37.21%(16/43),x2值12.181,3种病理材料MTB-PCR检测阳性率差异有统计学意义(P=0.002);3种病理材料联合行PCR检测阳性率88.37%(38/43)。[结论]活动性关节结核不同病理材料PCR检测阳性率有差异,多种病理材料联合检测可提高检测阳性率。
[Objective] To evaluate the detection results of polymerase chain reaction (PCR) in different pathological materials of active joint tuberculosis and to explore ways to improve the positive rate of PCR detection. [Methods] From January 2013 to December 2014, 43 cases of patients with advanced active tuberculosis underwent surgery to obtain pus, caseous tissue and granulation tissues respectively for detection of Mycobacterium tuberculosis (MTB) by fluorescence quantitative PCR. 23 males and 20 females; aged 15 to 74 years, mean 45.6 years old. Including knee tuberculosis in 20 cases, 15 cases of hip tuberculosis, shoulder tuberculosis in 3 cases, ankle tuberculosis in 3 cases, subtalar tuberculosis in 1 case, sacroiliac joint tuberculosis in 1 case. The positive rates of PCR detection of three different pathological materials were compared and analyzed. [Results] The positive rate of granulation tissue in 74.42% (32/43) was significantly higher than that in caseous tissue (58.14%) and pus (37.21%, 16/43), and the value of x2 was 12.181. Three kinds of pathological materials were detected by MTB-PCR The positive rate was statistically significant (P = 0.002). The positive rate of the three kinds of pathological materials detected by PCR was 88.37% (38/43). [Conclusion] The positive rates of PCR in different pathological materials of active joint tuberculosis are different. The joint detection of multiple pathological materials can increase the positive rate of detection.