TBNA在Ⅰ/Ⅱ期胸内结节病诊断中的应用价值  

Diagnostic value of transbronchial needle aspiration at stage Ⅰ and Ⅱ thoracic sarcoidosis

作　　者：李凯述[1] 刘明涛[1] 李燕燕[1] 欧阳修河[1] 

机构地区：[1]滨州市人民医院呼吸内科,山东滨州256610

出　　处：《临床肺科杂志》2017年第2期262-265,共4页Journal of Clinical Pulmonary Medicine

基　　金：滨州市科技发展计划项目(No 2015ZC0309)

摘　　要：目的探讨经支气管针吸活检(TBNA)在Ⅰ/Ⅱ期胸内结节病诊断中的应用价值。方法回顾性分析2012年1月至2015年6月期间在滨州市人民医院呼吸内科住院,根据胸片及胸部CT检查疑诊为Ⅰ/Ⅱ期胸内结节病且行TBNA联合TBLB及EBB检查的37例患者的临床资料。对上述各种检查方法的诊断阳性率进行统计学分析。结果 37例患者中,共确诊结节病29例,其中Ⅰ期11例,Ⅱ期18例。经TBNA检查确诊25例,诊断阳性率为86.2%,经TBLB检查确诊14例,诊断阳性率为48.3%,经EBB检查确诊9例,诊断阳性率为31%,TBLB联合EBB确诊16例,诊断阳性率为55.6%,三者的诊断阳性率与TBNA相比均存在统计学差异(P均<0.05)。TBNA联合TBLB、EBB确诊26例,诊断阳性率为89.7%,与TBNA相比无统计学差异(χ~2=0.00,P=1.00)。结论 TBNA在Ⅰ/Ⅱ期胸内结节病诊断中可以获得较高的诊断阳性率,TBLB、EBB与TBNA联合可以提高诊断阳性率,但提高不明显,因此,TBNA在Ⅰ/Ⅱ期胸内结节病的诊断中值得推广应用。Objective To investigate the application value of TBNA in diagnosing thoracic sarcoidosis at stage Ⅰ and Ⅱ. Methods The clinical data of 37 patients, being admitted to the respiratory department of Binzhou People＇s Hospital from January 2012 to June 2015 suspected with Ⅰ or Ⅱ thoracic sarcoidosis based on chest radiograph and chest CT examination, were retrospectively analyzed, and all those patients were given TBNA, TBLB and EBB examination. The diagnostic rate of above examinations were statistically analyzed. Results In 37 patients, 29 cases were diagnosed as sarcoidosis, of which 11 cases were at stage Ⅰ, and 18 cases at stage Ⅱ. 25 cases were diagnosed by TBNA only, and the diagnostic rate was 86. 2% （ 25/29 ）. The diagnostic rate of TBLB and EBB was 48.3% （14/29） and 31.0% （9/29）, respectively. TBLB combined with EBB could diagnose 16 cases, and the diagnostic rate was 55.6% （ 16/29 ）. There was no statistical difference in the diagnostic rate among TBNA, TBLB, EBB or the combination of TBLB and EBB （ P both 〈 0.05 ）. The combination of TBNA, TBLB, and EBB diagnosed a total of 26 cases, and while compared with TBNA, there was no statistically significant difference. Conclusion TBNA can get higher diagnostic rate in diagnosing thoracic sarcoidosis at stage I and II, TBLB, EBB and their combination can improve the diagnostic rate, but the improvement is not obvious. Therefore, TBNA is worthy of widely promotion in diagnosing thoracic sarcoidosis at stage Ⅰ and Ⅱ.

关 键 词：经支气管针吸活检 结节病 

分 类 号：R593.9[医药卫生—内科学]