结核性腹膜炎的实验室诊断

目的评价聚合酶链反应（ＰＣＲ）结合Ｓｏｕｔｈｅｒｎ杂交技术及酶联免疫吸附试验（ＥＬＩＳＡ）对结核性腹膜炎的诊断价值。方法用ＰＣＲ结合地高辛标记核酸探针Ｓｏｕｔｈｅｒｎ杂交技术检测４２例结核性腹水中结核分支杆菌ＤＮＡ，并与常规细菌学检测及ＥＬＩＳＡ对比。引物来自结核分支杆菌特异重复插入序列ＩＳ６１１０。特异性通过杂交及限制性内切酶ＳａｌⅠ酶切证实。同时比较了Ｓｏｕｔｈｅｒｎ杂交检测与凝胶电泳检测的敏感性。结果ＰＣＲ的敏感性为６９％，ＥＬＩＳＡ为７１％，培养为９％，涂片镜检均为阴性。并发现杂交较凝胶电泳检测更敏感。结论ＰＣＲ和ＥＬＩＳＡ法对结核性腹膜炎有较高的诊断价值，但前者更具有特异性。将Ｓｏｕｔｈｅｒｎ杂交技术与ＰＣＲ技术结合，可进一步提高检测的敏感性和特异性。

Laboratory diagnosis of tuberculous peritonitis

Objective To evaluate the diagnostic value of polymerase chain reaction(PCR)assay in combination with Southern hybridization technique and enzyme linked immunosorbent assay(ELISA) in tuberculous peritonitis.Methods Fourty two tuberculous ascites were detected for M.tuberculos is by PCR technique in combination with Southern hybridization,in which nuclear acid probe was digoxigenin labeled,and the result was compared with conventional bacteriological methods and ELISA.IS6110,a specific insert sequence of M.tuberculosis,was used as primer.The specificity of PCR products was confirmed by hybridization and digestion with Sal Irestrictive endonuclerase,and the sensitivity of hybridization was compared withgel electrophoresis .Results The sensitivities were 69% by PCR,71% by ELISA,9% by culture and 0 by acid fast staining respectively.Hybridization was found more sensitive than gel electrophoresis .Conclusions Both PCR technique and ELISA are valuable in diagnosis of tuberculous peritonitis,and the former is more specific than the latter.PCR technique in combination with Southern hybridization can improve both the sensitivity and the specificity of dectection.