矽肺结核及矽肺患者结核分支杆菌L型致病情况研究

Mycobacterium tuberculosis L forms in patients with pulmonary silicotuberculosis and silicosis

目的 探讨研究矽肺结核及矽肺患者结核分支杆菌L型致病情况的价值。方法 对矽肺结核组和矽肺组患者 ,分别进行痰结核分支杆菌和痰结核分支杆菌L型培养 ,并对结果进行对照观察。结果 矽肺结核组 6 0例痰结核分支杆菌培养阳性 6例 ,阳性率 10 %(同时出现结核分支杆菌L型培养阳性 5例 ,占 83 %) ;痰结核分支杆菌L型培养阳性 2 8例 (其中Ⅰ期矽肺结核L型菌检出率为33 %、Ⅱ期为 6 7%、Ⅲ期 10 0 %) ,阳性率 47%(P <0 0 1) ;矽肺组 30例无一例结核分支杆菌阳性 ,结核分支杆菌L型阳性 3例 ,占 10 %。结论 结核分支杆菌L型培养方便快速 ,能提高结核分支杆菌的检出率 ,对矽肺结核的早期诊断及减少矽肺结核复发的漏、误诊有肯定的价值 ;随着矽肺期别的上升 。

Objective To evaluate significance of Mycobacterium tuberculosis L forms in pathogenesis of silicotuberculosis and silicosis. Methods Sputum culture for Mycobacterium tuberculosis and its L forms was conducted from both silicotuberculosis and silicosis groups, and the results were compared. Results Among 60 silicotuberculosis patients, 6 (10%) were sputum Mycobacterium tuberculosis culture positive, of which 5 (83%) were Mycobacterium tuberculosis L forms culture positive; 28 were sputum Mycobacterium tuberculosis L forms culture positive (positive rates in the patients with silicosis stage Ⅰ, stage Ⅱ, stage Ⅲ were 33%, 67%, 100% respectively), with a positive rate of 47%, and a significant difference was found comparing with the frequency of detecting Mycobacterium tuberculosis ( P <0.01). All of the 30 cases with silicosis were Mycobacterium tuberculosis culture negative, however, 3 of them were sputum Mycobacterium tuberculosis L forms culture positive, accounting for 10 percent. Conclusions Sputum culture for Mycobacterium tuberculosis L forms is a convenient and rapid way to improve the detection rate of Mycobacterium tuberculosis , with a positive value in early diagnosis of silicotuberculosis by reducing misdiagnosis and underdiagnosis of this disease. Detection rate of Mycobacterium tuberculosis L forms significantly increases with deterioration of silicosis.