胸膜活检和胸液培养分枝杆菌联合运用对结核性胸膜炎的诊断价值  

Diagnostic value of combination with pleural biopsy and Mycobacteria Culture from pleural effussion in Tuberculous Pleurisy

作　　者：林敏芳[1] 方素芳[2] 黄恒灿[2] 

机构地区：[1]福建省人民医院/福建中医学院附属人民医院,福州350001 [2]福建医科大学福州肺科医院临床教学医院,福州350008

出　　处：《中国防痨杂志》2009年第10期579-582,共4页Chinese Journal of Antituberculosis

摘　　要：目的探讨胸液培养分枝杆菌、胸膜活检及其联合运用对结核性胸膜炎的诊断价值。方法通过对270例结核性胸膜炎(合并肺结核141例)患者分别同时行胸液培养分枝杆菌、胸膜活检术检查,观察并比较它们的阳性率及其联合运用的阳性率。结果单独行胸液培养分枝杆菌检查,阳性率41.1%:单独行胸膜活检术,阳性率65.2%,2种方法联用阳性率80.0%。联用方法与单独胸液培养组之间的差异具有统计学意义(χ2=85.476,P<0.01);与单独胸膜活检组之间的差异也有统计学意义(2χ=14.892,P<0.01)。结论2项检查均较安全,准确,对结核性胸腔积液诊断有显著意义,联合运用能大大提高确诊率,并能知道结核性胸腔积液是否是耐多药结核病(MDR-TB)和非结核分枝杆菌病(NTM)。Objective To explore the diagnostic value of combination with mycobacteria culture from pleural effusion and pleural biopsy or alone in patients with tuberculous pleurisy. Methods Mycobacteria culture from pleural effusion and pleural biopsy were carried out in 270 patients（including 141 cases with pulmonary tuberculosis） with tuberculous pleurisy. We observed and analyzed the positive rates of culture, biopsy and the combination. Results The positive rates of Mycobacteria culture from pleural effusion, pleural biopsy, and combination with two methods in patients with tuberculous pleurisy were 41.1%, 62.5%and 80.0% respectively. The rate of combination with two method were significant higher than those of mycobacteria culture from pleural effusion （X^2=85.476,P〈0.01） and pleural biopsy （X^2=14.892,P〈0.01）. Conclusion The methods of mycobacteria culture and pleural biopsy are safe and accurate with high value to dianose tuberculous pleurisy. Combination with pleural biopsy and mycobacteria culture may improve the rate of diagnosis. In addition, mycobacteria culture can identify whether mycobacteria strain isolated from pleural effusion is multidrug-resistant tuberculosis（MDR-TB） or non-tuberculous mycobacteria（NTM）.

关 键 词：结核 胸膜/诊断 胸膜 活组织检查 胸腔积液 分枝杆菌 结核 

分 类 号：R521.7[医药卫生—内科学]