支气管冲洗液涂片与培养在肺结核诊断中的价值分析  

Value of smear and isolation of bronchial lavage fluid in diagnosis of pulmonary tuberculosis

作　　者：曹翌明[1] 刘欣[1] 黄业伦[1] 黄艳君[1] 罗春明[1] 关平[1] 刘志辉[1] 刘健雄[1] 刘文 Cao Yiming;Liu Xin;Huang Yelun;Huang Yanjun;Luo Chunming;Guan Ping;Liu Zhihui;Liu Jianxiong;Liu Wen(Guangzhou Chest Hospital,Guangzhou 510095,China;Huadu District People's Hospital,Guangzhou 510800,China)

机构地区：[1]广州市胸科医院,510095 [2]广州市花都区人民医院,510800

出　　处：《国际医药卫生导报》2020年第12期1658-1660,共3页International Medicine and Health Guidance News

基　　金：“艾滋病和病毒性肝炎等重大传染病防治”国家科技重大专项(2018ZX10715004);广东省转化医学创新平台建设项目(省卫函[2018]1254号);广州市高水平临床重点专科和培育专科建设项目(穗卫函[2019]155号)。

摘　　要：目的探讨应用支气管冲洗液进行结核病病原学检查的临床应用价值。方法2019年1月至12月应用广州市胸科医院医学检验科LIS系统资料,对比分析在3周内并行痰、支气管冲洗液金胺O荧光染色涂片与分枝杆菌培养结果情况。结果115例患者支气管冲洗液直接涂片与痰直接涂片、307例患者支气管冲洗液夹层杯法涂片与其痰直接涂片比较,应用支气管冲洗液样本的阳性检出率显著低于痰样本(P<0.001,P=0.049);应用MGIT 960系统对882例患者支气管冲洗液和痰进行分枝杆菌培养,支气管冲洗液、痰的培养阳性率分别为37.53%和33.90%,而且89例(10.09%)痰培养阴性患者支气管冲洗液培养阳性,差异具有统计学意义(χ^2=353.555,P<0.001)。结论应用支气管冲洗液进行分枝杆菌培养是结核病病原学诊断的重要手段,而其涂片染色检查则价值不大。Objective To evaluate the clinical value of pathogen detection of pulmonary tuberculosis using bronchial lavage fluid as sample.Methods The data of laboratory information system from Guangzhou Chest Hospital between January and December,2019 were used;and the results of auramine O fluorescent stain smear and mycobacterial isolation of sputum and bronchial lavage fluid were comparatively analyzed.Results The positive rates of 115 bronchial lavage fluid smears or 307 sandwich cup collection smears of bronchial lavage fluid were significantly lower than those of the sputum smears(P<0.001 and P=0.049).The positive rates of Mycobacteria isolated from bronchial lavage fluid and sputum with the MGIT 960 system from the 882 patients were 37.53%and 33.90%,respectively.89 patients who were negative in sputum culture were positive in the culture of bronchial lavage fluid,accounting for 10.09%,with a statistical difference(χ^2=353.555,P<0.001).Conclusion Isolating mycobacterial from bronchial lavage fluid is an important method for the diagnosis of pulmonary tuberculosis,but the value of stain smear test is small.

关 键 词：结核 支气管冲洗液 抗酸菌涂片染色检查 分枝杆菌培养 

分 类 号：R521[医药卫生—内科学]