【摘要 】 目的 探讨痰菌阳性肺结核患者在治疗期及停药2年内痰结核分支杆菌及其DNA阴转情况与复发的关系以及聚合酶链反应(PCR)对菌阳肺结核患者治疗的监测价值。方法 用PCR技术、涂片及培养法对87例菌阳肺结核于治疗期每月检测1次，停药期继续随访2年。结果 痰结核分支杆菌PCR转阴时间通常比涂片和培养迟1～3个月，痰含菌量越多，PCR持续阳性时间越长。87例中10例(11%)PCR持续阳性1年以上，其中3例(30%)分别于停药后8、12、16个月时复发，1例PCR已转阴病例于18个月时复发。此4例均有痰菌复阳，胸片示病灶增多而再次接受治疗。结论 PCR用于临床疗效观察比涂片、培养实用，对估计有可能复发的病例有一定帮助。

An Sufang, Fan Yuhua.Guangzhou Hospital of Thorax, Guangzhou 510095

【Abstract 】 Objective To explore the relationship between sputum Mycobacteriumtuberculosis as well as its DNA negative conversion and relapse in bacillary pulmonarytuberculosis during chemotherapy and 2 years after completion of treatment, and toevaluate the value of polymerase chain reaction (PCR) technique in monitoring the efficacyof treatment. Method Eighty-sevenpatients with bacillary pulmonary tuberculosis were monthly examined by PCR technique,smear and culture methods, and were followed up for 2 years after treatment. Result The duration of sputum negative conversion by PCRtechnique was 1～3 months later than that bysmear and culture methods. The more the sputum bacteria, the longer the duration of PCRpositive results. Positive PCR results maintained in 10 out of 87 patients for more than 1year, among them 3 (30%) relapsed respectively at 8, 12 and 16 months after treatment. OnePCR negative conversion case relapsed at 18 months after treatment. These 4 cases whoregained sputum positive results and showed deterioration in chest X-ray films wereadmitted to hospital again. Conclusion PCR technique is more practical than smear and culture methods inmonitoring efficacy of the treatment of bacillary pulmonary tuberculosis, and is usefulfor evaluating cases with possible relapse.

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