不同支气管冲洗液结核分枝杆菌检测方法对菌阴肺结核的诊断价值

Diagnostic Value of Different Methods for Detecting Mycobacterium Tuberculosis in Bronchial Lavage Fluid

目的分析对结核分枝杆菌给予不同支气管冲洗液检测在菌阴肺结核诊断中的价值。方法回顾性分析2016年10月—2017年10月该辖区收治的60例菌阴肺结核患者的临床资料,所有患者均行支气镜检查。分别进行结核菌培养、支气管冲洗液涂片、噬菌体生物扩增法、荧光定量PCR法检测,记录检测结果,分析不同检测方法对菌阴肺结核的临床诊断价值。结果结核菌培养检测阳性率为56.67%,支气管冲洗液涂片检测阳性率为30.00%,噬菌体生物扩增法检测阳性率为15.00%,荧光定量PCR法检测阳性率为33.33%,结核菌培养检测的阳性率明显优于其他方法;噬菌体生物扩增法检测的阳性率明显低于其他方法 (χ~2=14.483 1,6.451 6,11.005 2,9.167 2,P<0.05)。结论结核菌培养是临床诊断菌阴肺结核的金标准,支气管冲洗液涂片、噬菌体生物扩增法对菌阴肺结核的阳性率相对较高,噬菌体生物扩增法的阳性率相对较低。

Objective This paper tries to analyze the different value of bronchial washings in the diagnosis of pulmonary tuberculosis in Mycobacterium tuberculosis. Methods The clinical data of 60 patients with bacterial yin and pulmonary tuberculosis admitted in this area from October 2016 to October 2017 were analyzed retrospectively. All the patients underwent bronchoscopy. Mycobacterium tuberculosis culture, bronchoalveolar lavage smear, phage biological amplification method, fluorescence quantitative PCR method were used to record the test results, and to analyze the clinical diagnostic value of different test methods. Results The positive rate of Mycobacterium tuberculosis culture was56.67%, the positive rate of bronchial fluid smear was 30.00%, the positive rate of phage biological amplification was15.00%, the positive rate was 33.33% by fluorescence quantitative PCR, The positive rate was significantly better than other methods. The positive rate of phage bioassay was significantly lower than other methods（cm^2=14.483 1,6.4516,11.005 2,9.167 2,P〈0.05）. Conclusion TB culture is the gold standard for clinical diagnosis of Yin negative pulmonary tuberculosis. The positive rate of sputum biological amplification is relatively high for sputum smear and pulmonary tuberculosis, and the positive rate of phage amplification is relatively low.