探讨改良抗酸染色法在结核性胸膜炎诊断中的应用价值  

Diagnostic value of improved Ziehl-Neelsen staining in tuberculous pleurisy

作　　者：张珣[1] 柳晓金 郑立恒[1] 周雪芹 李倩[1] 郑浩[3] ZHANG Xun;LIU Xiao-jin;ZHENG Li-heng;ZHOU Xue-qin;LI Qian;ZHENG Hao(Clinical Laboratory of Hebei Provincial Chest Hospital,Shijiazhuang,Hebei 050041,China;Fever Clinic of Hebei Provincial Chest Hospital,Shijiazhuang,Hebei 050041,China;Functional Division of Hebei Provincial Chest Hospital,Shijiazhuang,Hebei 050041,China)

机构地区：[1]河北省胸科医院检验科,河北石家庄050041 [2]河北省胸科医院发热门诊,河北石家庄050041 [3]河北省胸科医院功能科,河北石家庄050041

出　　处：《中国热带医学》2022年第5期454-457,共4页China Tropical Medicine

摘　　要：目的 建立改良抗酸染色法,并与离心涂片法和GENEN Xpert相比较,探讨改良抗酸染色法在结核性胸膜炎诊断中的应用价值。方法 应用改良抗酸染色法、离心涂片法、GENEN Xpert同时对84份临床诊断为结核性胸膜炎的胸腔积液标本进行检测,其中,胸腔积液多核细胞>50%的15例(多核为主组),多核细胞<50%的69例(单核为主组)。结果 84例胸腔积液改良抗酸染色法、离心涂片法、GENEN Xpert的阳性率分别为29.8%(25/84)、7.1%(6/84)、32.1%(27/84)。15例多核为主组改良抗酸染色法、离心涂片法、GENEN Xpert的阳性率分别为80.0%(12/15)、26.7%(4/15)、86.7%(13/15),69例单核为主组改良抗酸染色法、离心涂片法、GENEN Xpert的阳性率分别为18.8%(13/69)、2.9%(2/69)、20.2%(14/69),改良抗酸染色法与GENEN Xpert阳性率均高,比较差异无统计学意义(χ^(2)=0.111,P>0.05),改良抗酸染色法阳性率明显高于离心涂片法,比较差异有统计学意义(χ^(2)=14.28,P<0.05)。结论 改良抗酸染色法、离心涂片法、GENEN Xpert三种方法中,综合来说改良抗酸染色法诊断结核性胸膜炎阳性率高,经济、快速、简便,敏感性、特异性高,值得临床推广应用。ObjectiveWe aimed to establish an improved acid-fast staining method and compare it with the centrifugal smear method and GENEN Xpert to explore the application value of the improved acid-fast staining method in the diagnosis of tuberculous pleurisy.Methods pleurisy were examined by improved Ziehl-Neelsen stain, centrifugation smear and Genen Xpert. Among them, 15 cases with polynuclear cell more than 50% in hydrothorax(polynuclear group), and 69 cases with polynuclear cell lower than 50%(mononuclear group).Results Xpert were 29.8%(25/84), 7.1%(6/84) and 32.1%(27/84), respectively. The positive rates for polynuclear group were 80.0%(12/15), 26.7%(4/15) and 86.7%(13/15), respectively. And the positive rates for mononuclear group were 18.8%(13/69), 2.9%(2/69) and 20.2%(14/69), respectively. There was no significant difference between the positive rate of improved ZiehlNeelsen stain method and that of GENE Xpert method(χ^(2)=0.111,P>0.05). The positive rate of improved Ziehl-Neelsen stain was higher than that of Centrifugation smear(χ^(2)=14.28,P<0.05).ConclusionAmong the three methods of modified acid-fast staining method, centrifugation smear and GENEN Xpert, the improved Ziehl-Neelsen stain method has high positive rate in the diagnosis of tuberculous pleurisy. It is economical and rapid, and worthy of clinical application.

关 键 词：结核性胸膜炎 改良抗酸染色法 GENEN Xpert 离心涂片法 

分 类 号：R521.7[医药卫生—内科学]