检测支气管灌洗液中抗酸杆菌的方法学研究

Methodological studies on detecting acid-fast bacilli in bronchial perfusate

目的探讨检测支气管灌洗液中抗酸杆菌的最佳方法。方法对155例痰涂片阴性疑似肺结核患者的支气管灌洗液采用涂片、集菌、改良罗氏培养法及Bactec培养法4种不同的检测方法检测抗酸杆菌。结果阳性检出率直接涂片法为2.6%,集菌法为11.6%,改良罗氏培养法为18.1%,Bactec培养法为31.6%;集菌、培养法与直接涂片法抗酸杆菌的阳性检出率比较均有显著性差异(P<0.05)。结论对疑似肺结核患者支气管灌洗液进行抗酸杆菌检测时,最好采用集菌和培养法同时进行,才能为临床诊治提供最有价值的资料。

Objective To explore the best method of detecting acid-fast bacilli in bronchial perfusate. Methods Acid-fast bacilli in bronchial perfusate of 155 smear-negative patients with borderline pulmonary tuberculosis were detected with 4 different methods as smear technique, condensing method, modified Rosenbach＇s culture and Bactec culture to detect acid-fast bacilli. Results Positive detectable rates of the 4 methods were 2.6% of direct smear technique,11. 6% of condensing method, 18.1% of modified Rosenbach＇s culture and 31.6% of Bactec culture repectively. There were significant differences in positive detectable rates between the smear technique and the other 3 methods（P〈0.05）. Conclusion Combinations of condensing method and cultures detecting acid-fast bacilli in bronchial perfusate could provide value data for clinical diagnosis and treatment for patients with borderline pulmonary tuberculosis.