摘要
目的比较三种不同检测方法对涂阴肺结核患者痰液和支气管肺泡灌洗液结核分枝杆菌检测结果,探讨如何提高涂阴患者的病原学阳性率。方法选取2015年7月至2017年6月,衢州市人民医院住院患者117例,分别采用浓缩涂片抗酸染色、液体培养和Xpert MTB/RIF法检测痰液和肺泡灌洗液结核分枝杆菌,比较同种样本不同检测方法的阳性率。结果 117例涂阴患者痰液样本Xpert MTB/RIF检测、浓缩涂片抗酸染色、分枝杆菌液体培养阳性率分别为23.08%(27/117)、4.27%(5/117)、21.37%(25/117),117例涂阴患者肺泡灌洗液样本Xpert MTB/RIF检测、浓缩涂片抗酸染色、分枝杆菌液体培养阳性率分别为45.30%(53/117)、17.09%(20/117)、44.44%(52/117)。同种样本比较Xpert MTB/RIF和液体培养法阳性率高于浓缩涂片法,差异有统计学意义(χ~2=5.96,P<0.05)。不同种类样本比较,肺泡灌洗液3种方法阳性检出率均高于痰液同种方法,差异有统计学意义(χ~2=5.13,P<0.05)。结论对涂阴患者的样本进行液体培养和Xpert MTB/RIF检测可提高病原学阳性率。肺泡灌洗液检测能进一步提高阳性检出率。
Objective By comparing the results of three methods in the detection of Mycobacterium tuberculosis in sputum and bronchial alveolar lavage(BAL) samples collected from patients with smear-negative pulmonary tuberculosis(TB), to explore a better way for the further improvement in pathogen identification. Methods The sputum and BAL samples were collected from 117 inpatients with smear-negative TB in the People′s Hospital of Quzhou from July 2015 to June 2017.The concentrated smear anti-acid staining, liquid culture and Xpert MTB/RIF were used for the detection of Mycobacterium tuberculosis in the samples.The results were analyzed and compared. Results The positive rates of Xpert MTB/RIF, concentrated smear anti-acid staining, and Mycobacterium liquid culture were 23.08 %(27/117), 4.27 %(5/117), 21.37%(25/117) in sputum samples and were 45.30 %(53/117), 17.09 %(20/117), 44.44 %(52/117) in BAL samples of 117 smear-negative TB patients.The positive rates of Xpert MTB/RIF and liquid culture were higher than that of concentrated smear staining for the same sample type, the difference was statistically significant(χ^2=5.96, P<0.05).While, the positive rates of BAL samples using three methods were higher compared to that of sputum samples, the difference was statistically significant(χ^2=5.13, P<0.05). Conclusions The detection rate of Mycobacterium tuberculosis can be increased by performing liquid culture and Xpert MTB/RIF test,especially for BAL samples among patients with smear-negative TB.
作者
胡昌弟
余旭良
金菊仙
陆军
祝进
HU Chang-di;YU Xu-liang;JIN Ju-xian;LU Jun;ZHU Jin(Clinical Laboratory,the Peoples Hospital of Quzhou,Quzhou,Zhejiang 324000,China)
出处
《中国预防医学杂志》
CAS
CSCD
2019年第4期294-297,共4页
Chinese Preventive Medicine
基金
浙江省科技计划项目(2016C33238)
衢州市科技计划指导性项目(20172034)
关键词
涂阴肺结核
肺泡灌洗液
Xpert
MTB/RIF
浓缩涂片抗酸染色
液体培养
Smear-negative pulmonary tuberculosis
Bronchoalveolar lavage
Xpert MTB/RIF
Enrichment coating anti-acid staining
Liquid culture
