乙酰半胱氨酸雾化吸入导痰在儿童肺结核诊断中的应用效果  

APPLICATION EFFECT OF SPUTUM INDUCTION BY ACETYLCYSTEINE AEROSOL INHALATION IN THE DIAGNOSIS OF PULMONARY TUBERCULOSIS IN CHILDREN

作　　者：纪雪芹 褚晏 纪海玲 李同霞 JI Xueqin;CHU Yan;JI Hailing;LI Tongxia(Tuberculosis Department,Qingdao Chest Hospital,Qingdao 266043,China)

机构地区：[1]青岛市胸科医院结核科,山东青岛266043 [2]青岛市胸科医院检验科,山东青岛266043

出　　处：《精准医学杂志》2023年第6期511-513,共3页Journal of Precision Medicine

基　　金：山东省医药卫生科技发展计划项目(2021030808-83)。

摘　　要：目的分析乙酰半胱氨酸雾化吸入导痰在儿童肺结核诊断中的应用效果。方法将青岛市胸科医院收治的疑似肺结核患儿180例随机分组,对照组只开展常规痰检(主要包括浓缩集菌法、培养法和GeneXpert检测)寻找结核分枝杆菌,支气管镜组开展常规留痰加支气管镜留取肺泡灌洗液寻找结核分枝杆菌,乙酰半胱氨酸组开展常规留痰加乙酰半胱氨酸雾化吸入后留痰寻找结核分枝杆菌。计算各组患儿的痰液或肺泡灌洗液的结核分枝杆菌检出率、不良反应发生率并进行比较。结果对照组、支气管镜组及乙酰半胱氨酸组结核分枝杆菌检出率比较差异有显著性(χ^(2)=9.850,P<0.05),对照组与支气管镜组、乙酰半胱氨酸组比较差异有显著性(χ^(2)=8.889、6.009,P<0.05),支气管镜组与乙酰半胱氨酸组比较差异无显著性。对照组、支气管镜组和乙酰半胱氨酸组不良反应发生率比较差异有显著性(χ^(2)=27.705,P<0.05);三组间两两比较差异均有显著性(χ^(2)=7.685~25.455,P<0.05)。结论乙酰半胱氨酸雾化吸入导痰可显著提高儿童肺结核的诊断率,与加用支气管镜检查后结核分枝杆菌检出率相比无显著差异,但可使患儿免受支气管镜检查的痛苦,且不良反应发生率较低,值得进一步推广使用。Objective To investigate the application effect of aerosol inhalation of acetylcysteine in the diagnosis of pulmonary tuberculosis in children.Methods A total of 180 children suspected of pulmonary tuberculosis who were admitted to Qingdao Chest Hospital were enrolled and randomly divided into control group,bronchoscopy group,and acetylcysteine group.For the control group,routine sputum examination(including concentrated smear method,culture method,and GeneXpert test)was performed to identify Mycobacterium tuberculosis;for the bronchoscopy group,routine sputum examination combined with collection of alveolar lavage fluid by bronchoscopy was performed to identify Mycobacterium tuberculosis;for the acetylcysteine group,routine sputum examination combined with collection of sputum after aerosol inhalation of acetylcysteine was performed to identify Mycobacterium tuberculosis.The three groups were compared in terms of the detection rate of Mycobacterium tuberculosis in sputum or alveolar lavage fluid and the incidence rate of adverse reactions.Results There was a significant difference in the detection rate of Mycobacterium tuberculosis between the control group,the bronchoscopy group,and the acetylcysteine group(χ^(2)=9.850,P<0.05);there was a significant difference between the control group and the bronchoscopy group and between the control group and the acetylcysteine group(χ^(2)=8.889,6.009,P<0.05),while there was no significant difference between the bronchoscopy group and the acetylcysteine group.There was a significant difference in the incidence rate of adverse reactions between the control group,the bronchoscopy group,and the acetylcysteine group(χ^(2)=27.705,P<0.05),and there was also a significant diffe-rence between any two groups(χ^(2)=7.685-25.455,P<0.05).Conclusion Sputum induction by acetylcysteine aerosol inhalation can significantly improve the diagnostic rate of pulmonary tuberculosis in children,and there is no significant change in the detection rate of Mycobacterium tuberculosis after the ad

关 键 词：乙酰半胱氨酸 吸入法 结核 肺 结核分枝杆菌 诊断试验 常规 儿童 

分 类 号：R521[医药卫生—内科学] R446[医药卫生—临床医学]