Abstract：Objective To explore the role of detecting mycobacterium tuberculosis in menstrual blood for the diagnosis of female genital tuberculosis (FGTB) as a cause of infertility and recurrent abortion.Methods 145 women with infertility and recurrent abortion enrolled during October 2009 to March 2014 were detected mycobacterium tuberculosis by culture, smear and PCR in menstrual blood for the diagnosis of FGTB, and the results were compared with those from hysteroscopy and laparoscopy.Results 21 cases were diagnosed with genital tuberculosis by hysteroscopy or laparoscopy, with a rate of 14.5%. Of the 21 cases, 16 cases were infertile and 5 cases experienced recurrent abortion. Three cases were tuberculosis positive and 18 cases were negative by PCR in menstrual blood, and there was no positive by culture and smear. One cases showed tuberculosis positive by PCR in 124 women without genital tuberculosis and were all negative in culture and smear. The sensitivity and specificity of PCR was 14.3% and 99.2%. 18 cases were PPD strong positive in 21 cases diagnosed with genital tuberculosis; one case was PPD strong positive in 124 patients without genital tuberculosis.Conclusion Compared with traditional diagnostic methods, the detection of PCR in menstrual blood was more sensitive and positive rate would be improved if combined with PPD. However, further studies are needed for its use in the diagnosis of genital tuberculosis.
郭丽娜,王旭平,吕翠婷,贾新转. 月经血结核杆菌检测在女性生殖器结核诊断中的作用[J]. 中国生育健康杂志, 2017, 28(1): 10-12.
GUO Lina, WANG Xuping, LV Cuiting, JIA Xinzhuan. Detection of mycobacterium tuberculosis in menstrual blood for the diagnosis of female genital tuberculosis. Chinese Journal of Reproductive Health, 2017, 28(1): 10-12.
1 Ishrat S,Fatima P.Genital tuberculosis in the infertile women-an update.Mymensingh Med J,2015,24:215-220. 2 Thangappah RB,Paramasivan CN,Narayanan S.Evaluating PCR,culture & histopathology in the diagnosis of female genital tuberculosis.Indian J Med Res,2011,134:40-46. 3 Goel G,Khatuja R,Radhakfishnan G,et a1.Role of newer methods of diagnosing genital tuberculosis in infertile women.Indian J Pathol Microbiol,2013,56:155-157. 4 Sharma JB.Current diagnosis and management of female genital tuberculosis.J Obstet Gynaecol India,2015,65:362-371. 5 Ghosh K,Ghosh K,Chowdhury JR.Tuberculosis and female reproductive health.J Postgrad Med,2011,57:307-313. 6 Lortkipanidze GG,Vashakidze LM,Mamaladze TT,et al.Implication of laparoscopy in diagnostics of genital tb among women through cytohistological testing of bioptic specimen.Georgian Med News,2015,238:39-45. 7 林明媚,李蓉.女性生殖器结核性不孕症的诊治进展.中华妇产科杂志,2015,12:954-956. 8 Kulshrestha V,Kriplani A,Agarwal N,et al.Genital tuberculosis among infertile women and fertility outcome after antitubercular therapy.Int J Gynaecol Obstet,2011,113:229-234. 9 鲁曦,李王平,谢永宏,等.γ-干扰素释放试验在肺外结核诊断中的应用与评价.中华肺部疾病杂志(电子版),2016,9:20-25. 10 刘宝瑛,黎燕琼,李艳,等.女性生殖器结核早期诊断的研究.临床肺科杂志,2010,15:201-202. 11 沈科书,张淑芹,王峰,等.结核潜伏感染的新型诊断方法研究进展.中国老年学杂志,2015,35:2004-2007. 12 Sankar MM,Kumar P,Munawwar A,etal.Usefulness of multiplex PCR in the diagnosis of genital tuberculosis in females with infertility.Eur J Clin Microbiol Infect Dis,2013,32:399-405. 13 Rana T,Singh UB,Kulshrestha V,et al.Utility of reverse transcriptase PCR and DNA-PCR in the diagnosis of female genital tuberculosis.J Med Microbiol,2011,60:486-491. 14 Bhanothu V,Theophilus JP,Reddy PK,etal.Occurrence of female genital tuberculosis among infertile women:a study from a tertiary maternal health care research centre in South India.Eur J Clin Microbiol Infect Dis,2014,33:1937-1949. 15 Oosthuizen AP,Wessels PH,Hefer JN.Tuberculosis of the female genital tract in patients attending an infertility clinic.S Afr Med J,1990,77:562-564. 16 Sharma N,Sharma V,Singh PR,et al.Diagnostic Value of PCR in Genitourinary Tuberculosis.Ind J Clin Biochem,2013,28:305-308. 17 仇广翠.血性标本对实时荧光定量PCR检测的影响.齐齐哈尔医学院学报,2006,27:58.
