细胞蜡块抗酸染色在淋巴结结核诊断中的应用  

Application of Acid-fast Staining of Cell Wax Block in the Diagnosis of Lymph Node Tuberculosis

作　　者：彭海英 曾江 赖小菊 张润兰 PENG Haiying;ZENG Jiang;LAI Xiaoju;ZHANG Runlan(The Fifth People's Hospital of Ganzhou,Jiangxi Province,Ganzhou 341000,China;不详)

机构地区：[1]江西省赣州市第五人民医院,江西赣州341000

出　　处：《中国医学创新》2023年第22期135-138,共4页Medical Innovation of China

摘　　要：目的:探讨淋巴穿刺液细胞蜡块抗酸染色在淋巴结结核诊断中的应用价值。方法:纳入赣州市第五人民医院2021年1月—2022年6月收治的100例疑似淋巴结结核患者。所有患者均采集淋巴结抽吸液标本,均行直接涂片及细胞蜡块抗酸染色、瑞氏-吉姆萨染色、结核分枝杆菌培养,以结核分枝杆菌培养结果为金标准,比较不同方法诊断淋巴结结核的价值。结果:100例患者经结核分枝杆菌培养确诊淋巴结结核38例(38.00%)。涂片抗酸染色法诊断准确度为73.00%,敏感度为34.21%,特异度为96.77%;细胞蜡块抗酸染色法诊断准确度为85.00%,敏感度为78.95%,特异度为88.71%;瑞氏-吉姆萨染色法诊断准确度为83.00%,敏感度为73.68%,特异度为88.71%。以上三种方法与金标准的一致性Kappa值分别为0.351、0.680、0.634。结论:淋巴结穿刺液细胞蜡块抗酸染色法在淋巴结结核诊断中具有较高的诊断效能,相较于传统的涂片抗酸染色法、瑞氏-吉姆萨染色法,其诊断准确度更高。Objective:To explore the the value of acid-fast staining of cell wax block in lymphopuncture fluid in the diagnosis of lymph node tuberculosis.Method:A total of 100 patients with suspected lymph node tuberculosis admitted to the Fifth People's Hospital of Ganzhou from January 2021 to June 2022 were included.Lymph node aspiration fluid samples were collected from all patients,and all of them underwent direct smear and cell wax block acid-fast staining,Wright's-Giemsa staining and Mycobacterium tuber-culosis culture.Taking the result of Mycobacterium tuber-culosis culture as the gold standard,the value of different methods in the diagnosis of lymph node tuberculosis were compared.Result:Among 100 patients,38 cases(38.00%)were diagnosed as lymph node tuberculosis by Mycobacterium tuber-culosis culture.The diagnostic accuracy,sensitivity and specificity of smear acid-fast staining respectively was 73.00%,34.21%and 96.77%.The diagnostic accuracy,sensitivity and specificity of cell wax block acid-fast staining diagnostic respectively was 85.00%,78.95%and 88.71%.The diagnostic accuracy,sensitivity and specificity of Wright's-Giemsa staining respectively was 83.00%,73.68%and 88.71%.The consistency Kappa values between the above three methods and the gold standard respectively was 0.351,0.680 and 0.634.Conclusion:The acid-fast staining of cell wax block of lymph node aspiration fluid has higher diagnostic efficacy in the diagnosis of lymph node tuberculosis,compared with the traditional smear acid-fast staining and Wright's-Giemsa staining,the diagnostic accuracy is higher.

关 键 词：淋巴结结核 临床诊断 细胞蜡块技术 抗酸染色法 细胞学 

分 类 号：R522[医药卫生—内科学]