肺结核患者结核分枝杆菌L型培养的临床意义

Evaluation of the Clinical Value of Culturing the Mycobacterium Tuberculosis-Lister-Form from Pulmonary Tuberculosis Patients

目的了解肺结核患者MTB-L型的感染情况,并探讨其培养的临床意义。方法选取2004年1月～2004年12月确诊为肺结核患者的痰标本372例进行MTB-L型培养。结果MTB-L型总培养阳性率为16.7%。菌阳肺结核组MTB-L型培养阳性率为21.8%,菌阴组为9.6%;活动性肺结核组MTB-L型培养阳性率为18.6%,非活动性组为2.5%,两者差异极显著(P<0.01);服药时间>6个月组MTB-L型培养阳性率为33.8%,服药时间<1个月组MTB-L型培养阳性率为10.9%,两者有极显著差异(P<0.01)。初治肺结核组MTB-L型培养阳性率为13.9%,复治组MTB-L型培养阳性率为35.4%,两者差异极显著(P<0.01)。结论肺结核患者MTB-L型感染占一定比例,服药时间>6个月和复治的患者MTB-L型感染率较高,若在痰结核分枝杆菌培养的同时进行MTB-L型培养,不仅可使肺结核患者细菌学的诊断率提高一定比例,而且对肺结核患者的治疗以及判断预后也具有重要意义。

Objective To study the infection of mycobacterium tuberculosis-lister-form（MTB-L） in pulmonary tuberculosis patients and investigate the clinical value of culturing MTB-L. Methods 372 sputum samples of pulmonary tuberculosis patients were collected in our station from January 2004 to December 2004 and MTB-L were cultured from the samples. Results The culture-positive rate of MTB-L of all pulmonary tuberculosis patients was 16.7%. The culture-positive rates of MTB-L of mycobacterium tuberculosis （MTB） positive group and negative group were 21.8% and 9.6%, respectively. The culture-positive rate of MTB-L in the active pulmonary tuberculosis patients （18.6%） was higher than that in the non-active pulmonary tuberculosis patients （2.5%） （P〈0.01）. Patients received treatments 〉 six months have a higher culture-positive rate （33.8%） than the patients received treatments 〈 one month （10.9%） （P〈 0.01）. The culture-positive rates of MTB-L of the new patients and retreated patients were 13.9% and 34.5%, respectively. There was statistical differences in the two groups （P〈0.01）. Conclusion There was a certain percentage of pulmonary tuberculosis patients were infected by MTB-L. The MTB-L infection rate was high in the retreated patients and the patients received treatments 〉 six months. The culture of MTB-L can improve bacteriological diagnosed rate of the pulmonary tuberculosis and is also important for prognosis and designing the therapy.