1243例患者支气管冲洗液三种结核分枝杆菌检查结果分析  

Analysis of results of detecting Mycobacterium tuberculosis in bronchial lavage fluid by three methods among 1243 cases

作　　者：曹翌明[1] 苏碧仪[1] 钟炳棠[1] 李雪雅[1] 马品云 彭德虎[1] 刘志辉[1] 刘健雄[1] 张言斌[1] 刘文 Cao Yiming;Su Biyi;Zhong Bingtang;Li Xueya;Ma Pinyun;Peng Dehu;Liu Zhihui;Liu Jianxiong;ZhangYanbin;Liu Wen(Guangzhou Chest Hospital,Guangzhou 510095,China;Huadu District People's Hospital in Guangzhou,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11期1511-1514,共4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);广东省转化医学创新平台建设项目(省卫函[2018]1254号)。

摘　　要：目的探讨支气管冲洗液检测结核分枝杆菌DNA与RNA的临床诊断价值。方法对广州市胸科医院2019年1243例患者应用同次支气管冲洗液样本并行分枝杆菌培养、结核分枝杆菌DNA和RNA检测结果与临床诊断资料进行回顾性分析。结果获得“培养(+)+DNA(+)+RNA(+)”“培养(+)+DNA(+)+RNA(-)”“培养(-)+DNA(-)+RNA(+)”“培养(-)+DNA(-)+RNA(-)”4种组合结果,在1243例患者样本中其百分构成分别为20.51%(255/1243)、13.27%(165/1243)、8.53%(106/1243)和57.68%(717/1243)。在769例肺结核患者样本中则分别为33.16%(255/769)、21.46%(165/769)、10.40%(80/769)和34.98%(269/769),其中无空洞肺结核与空洞肺结核患者中培养阳性与DNA同时阳性的百分率分别为50.00%(290/580)和68.78%(130/189),有空洞者显著高于无空洞者(χ^2=20.293,P<0.01)。结论支气管冲洗液结核分枝杆菌DNA检测性能与培养等效,且在检测快速方面具有培养无可比拟的优越性,值得临床推广应用。Objective To evaluate the value of detecting DNA and RNA of Mycobacterium tuberculosis in bronchial lavage fluid for diagnosis of tuberculosis.Methods The data of 1243 cases from Guangzhou Chest Hospital in 2019,who were performed bronchoscopy and their samples of bronchial lavage fluid were tested for isolation of Mycobacteria and DNA and RNA detection of Mycobacterium tuberculosis at the same time,were collected and analyzed respectively.Results The four combinations of detection including“isolation positive plus DNA positive plus RNA positive”,“isolation positive plus DNA positive plus RNA negative”,“isolation negative plus DNA negative plus RNA positive”,and“isolation negative plus DNA negative plus RNA negative”were presented.And their percentage composition were 20.51%(255/1243),13.27%(165/1243),8.53%(106/1243),57.68%(717/1243)among all of 1243 cases,while they were 33.16%(255/769),21.46%(165/769),10.40%(80/769),34.98%(269/769)among 769 patients with pulmonary tuberculosis.Compared with 50.00%(290/580)positive ratio of both isolation and DNA detection among patients with non-cavernous pulmonary tuberculosis,it was 68.78%(130/189)among patients with cavernous pulmonary tuberculosis,the latter was significantly higher than the former(χ^2=20.293,P<0.01).Conclusion DNA detection of Mycobacterium tuberculosis in bronchial lavage fluid is worthy of extensive promotion and application in clinical diagnosis and treatment because its performance is equivalent to isolation of Mycobacteria and it is especially rapid for getting test result compared with isolation of Mycobacteria.

关 键 词：结核 支气管冲洗液 结核分枝杆菌 培养 核酸检测 

分 类 号：R521[医药卫生—内科学]