【摘要】 目的探讨手部慢性肉芽肿性炎症的病因,其病理改变的鉴别诊断意义及PCR测序在诊断中的价值。方法以16S-rDNA为靶序列,采用Nest-PCR/核酸测序法直接检测37例病理表现为手部慢性肉芽肿性炎症的新鲜标本中的分枝杆菌。结果24例PCR扩增出阳性条带,测序结果为海分枝杆菌17例,鸟分枝杆菌2例,龟脓肿分枝杆菌1例,堪萨斯/胃分枝杆菌2例,结核杆菌2例。结论PCR直接检测手部标本中的分枝杆菌可确定病因,非结核分枝杆菌是手部慢性肉芽肿性炎症的主要病因,病理改变不足以区别结核与非结核,应进一步找出细菌学证据。更多还原

【Abstract】 Objective To explore the causative pathogens in littoral hand infections which exhibited chronic granulomatous inflammation, the relationship between chronic granulomatous inflammation and mycobacteria and to discuss the prospects of PCR in clinical application for diagnosis of granulomatous inflammation. Method With 16S-rDNA as the target sequence,Nest-PCR was used to detect mycobacteria directly from 37 cases of chronic granulomatous inflammations,and identified them by gene sequencing.Results Twenty-four of 37 cases were positive for mycobacteria by Nest-PCR, in which 17 were M.marinum, 1 M.chelonae, 2 M.avium, 2 M.kansasii,and 2 M. tubercular through gene sequencing.Conclusions Nest-PCR combining gene sequencing proved to be a liable and sensitive method to detect Non-tubercular mycobacteria (NTM) in fresh tissue. NTM is the major factor of hand specific chronic infections other than tubercular. Pathological changes are difficult to differentiate TB from NTM and bacterial evidence was necessary.更多还原