应用改良抗酸染色法诊断胸腔炎患者结核杆菌感染的效果分析

Effect of modified acid-fast staining method on diagnosis of Mycobacterium tuberculosis infection in patients with thoracic inflammation

目的分析改良抗酸染色法对结核性胸膜炎患者胸腔积液中结核分歧杆菌的诊断价值。方法回顾性分析2018年1-12月某医院收治的127例胸腔积液(恶性胸腔积液患者30例,结核性胸腔积液患者97例)患者临床资料,入选者标本均同时采用传统Ziehl-Neelsen抗酸染色、改良抗酸染色法检查。观察比较两种方法的检查结果,以结核菌培养结果作为金标准方法,评价方法的敏感度、特异度、准确率,计算约登指数。结果传统抗酸染色法敏感度、特异度、准确率分别为:54.64%、83.33%、61.42%,改良抗酸染色法敏感度为80.41%、特异度为96.67%、准确率为84.25%,二者差异有统计学意义(P<0.05);改良抗酸染色法约登指数(0.77)高于传统抗酸染色法(0.38)。结论改良抗酸染色法有助于提升结核分歧杆菌检出率,较适于为结核性胸膜炎的诊断实验。

Objective To evaluate the value of modified acid-fast staining method on the diagnosis of Mycobacterium tuberculosis infection in patients with thoracic inflammation. Methods The clinical data of 127 patients with pleural effusion(30 patients with malignant pleural effusion and 97 patients with tubercular pleural effusion) were retrospectively analyzed. The specimens of the patients were tested by the conventional Ziehl-Neelsen acid-fast staining method and the modified acid-fast staining at the same time, and the test results of the two methods were compared. The sensitivity, specificity and accuracy of the methods were evaluated by using the culture results of M. tuberculosis as the golden standard, and Youden index was also calculated. Results The sensitivity, specificity and accuracy of the conventional acid-fast staining method were 54.64%, 83.33%, 61.42%, respectively, and the sensitivity, specificity and accuracy of the modified acid-fast staining method were 80.41%, 96.67%, and 84.25%, respectively, and there were significant differences between the two methods(P<0.05). The Youden index of the modified acid-fast staining method was 0.77, which was higher than that of the conventional acid-fast staining method. Conclusion The modified acid-fast staining method can improve the detection rate of M. tuberculosis, and is suitable for the diagnosis of tuberculous pleurisy.