改良抗酸染色法诊断结核性胸膜炎的应用价值分析  

Application value analysis of modified acid-fast staining in diagnosis of tuberculous pleurisy

作　　者：龚明峰[1] 魏晓宇[1] 聂思瑶 田文广[1] 丁静[1] GONG Ming-feng;WEI Xiao-yu;NIE Si-yao(Department of Infectious Diseases,Yongchuan Hospital of Chongqing Medical University,Chongqing 402160,China)

机构地区：[1]重庆医科大学附属永川医院感染科,402160

出　　处：《中国实用医药》2023年第12期88-91,共4页China Practical Medicine

基　　金：永川区自然科学基金计划项目(项目编号:Ycstc,2018nb0206)。

摘　　要：目的 分析改良抗酸染色法在结核性胸膜炎诊断中的应用价值。方法 47例胸腔积液患者为研究对象,根据胸水常规、生化等检查结果分为病例组(结核性胸腔积液,35例)及对照组(非结核性胸腔积液,12例)。两组患者的胸水标本均进行传统抗酸染色法、改良抗酸染色法、结核分枝杆菌培养及结核分枝杆菌核酸检测。观察传统抗酸染色法、改良抗酸染色法、结核分枝杆菌培养、结核分枝杆菌核酸检测的结果;以结核分枝杆菌培养结果作为金标准,对比改良抗酸染色法与传统抗酸染色法的诊断效能。结果 病例组传统抗酸染色法阳性检出率为5.71%,改良抗酸染色法阳性检出率为8.57%,结核分枝杆菌培养阳性检出率为17.14%,结核分枝杆菌核酸检测阳性检出率为45.71%。传统抗酸染色法与改良抗酸染色法的阳性检出率比较,差异无统计学意义(P>0.05)。以结核分枝杆菌培养结果作为金标准,改良抗酸染色法诊断灵敏度为50.00%,特异度为100.00%;传统抗酸染色法诊断灵敏度为33.33%,特异度为100.00%。改良抗酸染色法与传统抗酸染色法的诊断灵敏度、特异度比较,差异无统计学意义(P>0.05)。结论 单一的检测方法在结核性胸膜炎的诊断中各有优劣势,价值有限,需要联合多种检测方法,以提高胸腔积液中结核分枝杆菌检出率,由于本研究样本例数偏少,故应扩大样本量进一步研究,为结核性胸膜炎的早期诊断提供依据。Objective To analyze the application value of modified acid-fast staining in diagnosis of tuberculous pleurisy.Methods A total of 47 patients with pleural effusion were studied and divided into case group(tuberculous pleurisy,35 cases)and control group(non-tuberculous pleurisy,12 cases)according to the results of routine and biochemical examination of pleural effusion.All pleural fluid specimens were subjected to conventional acid-fast staining,modified acid-fast staining,Mycobacterium tuberculosis culture,and nucleic acid test of Mycobacterium tuberculosis.The results of conventional acid-fast staining,modified acid-fast staining,culture of Mycobacterium tuberculosis,and nucleic acid detection of Mycobacterium tuberculosis were observed.The culture results of Mycobacterium tuberculosis were used as the gold standard to compare the diagnostic efficacy of modified acid-fast staining method and conventional acid-fast staining.Results In the case group,the positive detection rate was 5.71%for conventional acid-fast staining,8.57%for modified acid-fast staining,17.14%for Mycobacterium tuberculosis culture,and 45.71%for nucleic acid test of Mycobacterium tuberculosis.There was no statistically significant difference in the positive detection rate between the conventional acid-fast staining and the modified acid-fast staining(P>0.05).Using the results of Mycobacterium tuberculosis culture as the gold standard,the diagnostic sensitivity of the modified acid-fast staining was 50.00%and the specificity was 100.00%;the diagnostic sensitivity of the conventional acid-fast staining was 33.33%,and the specificity was 100.00%.The differences between the diagnostic sensitivity and specificity of the modified acid-fast staining and the conventional acid-fast staining were not statistically significant(P>0.05).Conclusion Single detection methods have their own advantages and disadvantages in the diagnosis of tuberculous pleurisy,and their value is limited.It is necessary to combine multiple detection methods to improve the detect

关 键 词：改良抗酸染色法 结核性胸膜炎 诊断价值 

分 类 号：R521.7[医药卫生—内科学]