CAJ | 학술논문

目的：分析结核性脑膜炎（tuberculous meningitis，TBM）脑脊液细胞数变化，探讨其与脑脊液中结核分枝杆菌实时荧光定量聚合酶链反应（real-time fluorescent quantitative PCR，FQ-PCR）检测阳性的相关性。方法选取确诊的结核性脑膜炎患者81例，应用全自动血液－体液细胞分析仪进行脑脊液细胞总数计数、离心甩片作脑脊液细胞涂片，光学显微镜图像分析系统分类计数，应用 FQ-PCR 法检测脑脊液中结核分枝杆菌，两者进行相关性分析。结果 FQ-PCR 法检测 TB-DNA 阳性率为50．6％（41／81），其中 FQ-PCR 阳性组中白细胞总数高于阴性组（P ＜0．05）。且白细胞数与 FQ-PCR 拷贝数呈正相关。FQ-PCR 阳性中脑脊液细胞学表现：以混合型细胞反应为主，其中淋巴细胞比例0．590，中性粒细胞比例0．366。结论结核性脑膜炎脑脊液细胞学大多以淋巴细胞反应为主，脑脊液白细胞数的变化可以反映疾病的严重程度，与 FQ-PCR 联合检测对早期诊断结核性脑膜炎有一定的意义。
목적：분석결핵성뇌막염（tuberculous meningitis，TBM）뇌척액세포수변화，탐토기여뇌척액중결핵분지간균실시형광정량취합매련반응（real-time fluorescent quantitative PCR，FQ-PCR）검측양성적상관성。방법선취학진적결핵성뇌막염환자81례，응용전자동혈액－체액세포분석의진행뇌척액세포총수계수、리심솔편작뇌척액세포도편，광학현미경도상분석계통분류계수，응용 FQ-PCR 법검측뇌척액중결핵분지간균，량자진행상관성분석。결과 FQ-PCR 법검측 TB-DNA 양성솔위50．6％（41／81），기중 FQ-PCR 양성조중백세포총수고우음성조（P ＜0．05）。차백세포수여 FQ-PCR 고패수정정상관。FQ-PCR 양성중뇌척액세포학표현：이혼합형세포반응위주，기중림파세포비례0．590，중성립세포비례0．366。결론결핵성뇌막염뇌척액세포학대다이림파세포반응위주，뇌척액백세포수적변화가이반영질병적엄중정도，여 FQ-PCR 연합검측대조기진단결핵성뇌막염유일정적의의。
Objective To analyze the cell count of cerebrospinal fluid in tuberculous meningitis(TBM)and explore the association of test positive for Mycobacterium tuberculosis by real time fluorescent quantitative PCR(FQ-PCR)and cell count.Methods The study selected 81 patients with tuberculous meningitis.Cerebrospinal fluid cell was counted by automatic blood-body fluid cytoanalyzer,cell smears of cerebrospinal fluid were made by centrifugal machine and cells were classified by image analysis system of optical microscope.Mycobacterium tuberculosis in cerebrospinal fluid was detected by FQ-PCR and its correlation with cell count was analyzed. Results The positive rate of M.tuberculosis DNA(TB-DNA)by FQ-PCR method was 50.6%(41/81).The leukocyte count of FQ-PCR positive group was higher than that of the negative group(P <0.05).The leukocyte number was positively correlated with the copy number of FQ-PCR.The characteristics of cerebrospinal fluid cytology in FQ-PCR positive group indicated that the mixed cellular reaction was dominant,and the lymphocytes ratio was 0.590,while neutrophils ratio was 0.366.Conclusion The cerebrospinal fluid cytology of tuberculous meningitis is mostly lymphocyte reaction,cerebrospinal fluid leukocyte count in combination with PCR can reflect the severity of disease and has certain significance for the early diagnosis of tuberculous meningitis.