肺结核患者痰涂片抗酸染色检查结果与咳嗽咳痰时间及胸部X线影像学特征的相关性

Correlation of Ziehl-Neelsen stain examination of sputum smear with cough time and chest X-ray radiographic features in cases with pulmonary tuberculosis

目的 探讨痰涂片抗酸染色检查结果与肺结核患者就诊前咳嗽咳痰时间、胸部X线影像学特征之间的关联性,为深层次理解肺结核的传播影响因素提供科学依据。方法 查阅本院第一门诊部2006至2015年广州市结核病控制项目初诊患者登记本,统计咳嗽咳痰、胸片结果、痰检结果资料,以-、1+、2+、3+、4+痰涂片抗酸染色检查结果将肺结核患者分组,应用χ^2检验比较分析痰涂片显微镜检查结果与诊前咳嗽咳痰时间长短(无、<2周、≥2周)、有无空洞、病变肺野分布(1~6个)等的相关性。结果 共登记5235例肺结核患者,痰涂片抗酸染色显微镜检查4+、3+、2+、1+、-患者分别为304、213、305、973和3440例。经χ^2检验:⑴不同组间咳嗽咳痰时间无、<2周、≥2周的总体构成比不同或不完全相同,χ^2=284.170,P=0.000;Cramer氏V系数(下称“V”)、校正Pearson列联系数r'(下称“r'”)分别为0.16和0.28,涂片检查阳性等级与咳嗽时间长短呈正相关。⑵不同组间有无空洞的总体构成比不同,χ^2=868.661,P=0.000;V、r'分别为0.41和0.53,涂片检查阳性等级与空洞密切相关。⑶不同组间病变肺野分布(1~6个)的总体构成比不同或不完全相同,χ^2=524.543,P=0.000;V、r'分别为0.18和0.37,涂片检查阳性等级与病灶累及肺野多寡呈正相关。结论 肺结核患者痰涂片抗酸染色检查阳性等级与咳嗽时间长短、病变累及肺野多寡和病灶空洞有无均存在一定的关联性,且相关程度由弱到强。

Objective To explore the correlation of Ziehl-Neelsen stain examination of sputum smear with cough time and chest X-ray radiographic features in patients with pulmonary tuberculosis,and to comprehend the risk factors of tuberculosis transmission.Methods The data from Guangzhou Tuberculosis Control Project New Cases Registration Book,including cough time,chest X-ray radiography,and Ziehl-Neelsen stain examination of sputum smear of new cases with pulmonary tuberculosis in the first outpatient department of our hospital from 2006 to 2015,were applied to analyzed the correlation of Ziehl-Neelsen stain examination of sputum smear with cough time and chest X-ray radiographic features byχ^2 test.In the analysis,the cases were classified into five groups according to 4+、3+、2+、1+、-of Ziehl-Neelsen stain examination of sputum smear;according to the cough time,they were grouped into three kinds of duration--none,less than two weeks(<2 weeks),and at least two weeks(≥2 weeks);the chest X-ray radiographic features included the presence and absence of cavity as well as the distribution of lesions in six lung fields(from one to six).Results 5 235 cases with pulmonary tuberculosis were enrolled;and the number of the five case groups from 4+to-were 304,213,305,973,and 3,440,respectively.The analysis results were as follows.The overall percentages of the three kinds of duration were different or incompletely the same(χ^2=284.170,P=0.000)in the five case groups;the Cramer's V coefficient(for short“V”)and corrected contingency coefficient(for short“r′”)were 0.16 and 0.28,and there was a positive correlation between the positive level of sputum smear examination and cough duration.The overall percentages of those with or without cavity were different(χ^2=868.661,P=0.000);V and r′were 0.41 and 0.53,and the positive level of sputum smear examination was closely related to the cavity.The overall percentages of the numbers of lung fields involved were different or incompletely the same(χ^2=524.543,P=0.000);V and r′were 0.18 and 0.37,and there was a positive correlation between the positive level of sputum smear examination and the number of lung fields involved.Conclusions The positive level of sputum smear examination relates to cough duration,cavity,and the number of lung fields involved;and the correlation degree is from weak to strong according to this order.