中文摘要：

目的研究颈部分枝杆菌淋巴结炎病原菌的类型以提高疾病的诊断水平。方法选取分枝杆菌性淋巴结炎73例，标本类型为脓液41例，淋巴结组织32例，肺癌淋巴结转移21例，使用巢式PCR扩增热休克蛋白65（hsp65）基因的部分序列，将扩增产物与GENEBANK序列比对，研究分枝杆菌属的类型，同时，对淋巴结标本常规行抗酸染色和改良罗氏培养。结果标本类型为脓液的病例41例，抗酸染色阳性3例，分枝杆菌属培养阳性4例，巢式PCR阳性30例，比对后为结核分枝杆菌28例，脓肿分枝杆菌和偶然分枝杆菌各1例；标本类型为淋巴结组织的病例32例，抗酸染色和分枝杆菌培养均为阴性，巢式PCR阳性14例，比对后全部为结核分枝杆菌，两种标本类型巢式PCR阳性率差异有统计学意义（P〈0．05）；21例肺癌淋巴结转移病例，l例巢式PCR阳性，巢式PCR诊断分枝杆菌性淋巴结炎的敏感性60．3％、特异性95．3％。结论巢式PCR具有较高的敏感性和特异性，可用于临床标本的菌种鉴定。

英文摘要：

Objective To study the species of pathogenic bacteria causing mycobacterial cervical lymphadenitis so as to improve the diagnosis of disease. Methods A total of 73 cases of mycobacterial lymphadenitis （including 41 cases with pus samples and 32 cases with lymphatic tissue samples） and 21 cases of lymph node metastasis of lung cancer were enrolled in the study, then the nested-PCR was employed to amplify some heat shock protein 65 （hsp 65） gene sequences, the amplified products were compared with the squences for GENBANK, the species of mycobacterium were observed, and the routine acid-fast staining and modified Lowenstein-Jensen culture were performed for the lymph nodes specimens. Results Among the 41 cases with pus samples, there were 3 cases positive for acid-fast staining, 4 cases cultured positive for Mycobacterium, and 30 cases tested positive for nested-PCR, by in contrast, there were 28 strains of Mycobacterium tuberculosis, 1 strain of Mycobacterium abscessus, and 1 strain of Mycobacterium fortuitum. Among the 32 cases with lymphatic tissue samples, all the cases were negative for the acid-fact staining and the culture of Mycobacterium, there were 14 cases tested positive for nested-PCR, by comparison, all the species were identified as the M.tuberculosis; the difference in the positive rate ofnested-PCR between the two types ofspecimans was statistically significant （P〈0.05） ; there were 21 cases of lymph nodes metastasis of lung cancer and 1 case tested positive for nested-PCR.The sensitivity of the nested-PCR in diagnosis of mycobacterial lymphadenitis was 60.3%, the specificity 95.3%. Conclusion The nested-PCR has high sensitivity and specificity in the identification of the bacterial species isolated from clinical specimens.