支气管镜检查对艾滋病痰菌阴性肺结核的诊断价值

Clinical value of bronchoscopy in diagnosis of AIDS combined bacteria sputum negative pulmonary tuberculosis

目的探讨电子支气管镜检查在艾滋病(AIDS)中对痰菌阴性肺结核的应用价值。方法回顾性分析该院诊断为AIDS且临床表现、胸部CT、实验室检查高度怀疑肺结核且痰结核菌阴性的65例患者支气管镜肺泡灌洗液抗酸染色涂片(BAL)、灌洗液结核分枝杆菌培养、刷检、活检结果。结果 65例病例中,BAL液抗酸染色涂片阳性14例(21.54%),BAL液结核分枝杆菌培养阳性20例(30.76%),支气管镜刷检阳性24例(36.92%),35例根据支气管镜下表现予以支气管镜活检,阳性21例(60.00%),支气管镜联合不同方法确诊43例(66.15%)。结论在AIDS患者中,对痰菌阴性且高度怀疑肺结核患者进行支气管检查具有重要诊断意义。

Objective To evaluate the value of utility of bronchoscopy in human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) patients with Bacteria sputum negative pulmonary tuberculosis. Methods Bronchoscopy was conducted to 65 AIDS patients with bacteria sputum negative pulmonary tuberculosis in the first hospital of Changsha. The patients’ bronchoalveolar lavage fluid through the electronic bronchoscopy, mycobacterium tuberculosis (MTB) culture, brushings and biopsy pathology were analyzed. Results 65 cases, bronchoscope alveolar lavage fluid smear positive acid-fast stain 14 cases (21.54%),BAL mycobacterium tuberculosis culture positive 20 cases (30.76%), a bronchoscope brush positive 24 cases (36.92%), 35 cases of bronchoscopy biopsy, according to the performance under the bronchoscope positive 21 cases (60.00%), bronchoscopy combined different methods confirmed 43 cases (66.15%). Conclusions Bronchoscopy in AIDS with bacteria sputum negative pulmonary tuberculosis diagnosis, it has important application value.