microRNA与结核病诊断的研究进展

microRNA(miRNA)是一类存在于真核细胞中的非编码小RNA,可以调控基因转录后表达。人体中30%以上的基因都受miRNA的调控,同时miRNA还可作为不同生理和病理状态的分子标记。尽管已经在各种生物中预测并证实了数百种miRNA,但miRNA及其靶基因的明确作用机制和功能尚不完全明了。许多研究表明,miRNA与肺部疾病感染的发生、发展及转化有着密切的关联。miRNA在肺部疾病的正负调节功能为细菌性肺部疾病的诊断和治疗提供了新方向。我们简述了miRNA在潜伏性肺结核病和活动性肺结核病诊断领域的研究进展。     

Diagnosis of Tuberculosis in a General Hospital

In a survey of 71 new cases of tuberculosis diagnosed in a general hospital the average interval between admission and diagnosis of tuberculosis (the diagnostic interval) ranged between 10 days for intrathoracic tuberculosis and 20 days for genitourinary tuberculosis. The average diagnostic interval was 10·9 days when tuberculosis was included in the initial differential diagnosis, and 22·8 days when other diagnoses were made. Undue delay in diagnosis occurred in 17 patients (24%). In eight this was due to failure to include tuberculosis in the initial differential diagnosis. Earlier diagnosis might have saved three of the five patients who died.In 21 patients (30%) a history of predisposing factors or associated illness was obtained. Ten of these had suffered from previous tuberculosis.The vital factor in diagnosis of tuberculosis in general hospital patients is consideration of this condition in the diagnosis of any unexplained illness, especially where a history of previous tuberculosis or a recognized predisposing factor is obtained.