直接涂片法与液基细胞学涂片法检测痰抗酸杆菌的价值比较

Comparison of detection values of acid-fast bacilli in sputum by direct smear versus liquid-based cytology smear

目的比较直接涂片法、液基细胞学涂片法对痰抗酸杆菌的检测价值。方法选择2018年5月至2019年5月滨州市中心医院收治的肺结核患者4000例,取其夜间痰、晨痰各1份,共8000份标本,分别采用直接涂片法及液基细胞学涂片法进行检验,记录两种方法对痰抗酸杆菌的阳性检出率。结果液基细胞学涂片法及直接涂片法对清晨痰抗酸杆菌的阳性检出率分别为30.33%(2426/4000)、21.55%(1724/4000),对夜间痰抗酸杆菌的阳性检出率分别为22.34%(1787/4000)、12.40%(992/4000)。与夜间痰相比,两种检测方法均对清晨痰抗酸杆菌的阳性检出率较高,差异有统计学意义(P<0.05);与直接涂片法相比,液基细胞学涂片法对清晨、夜间痰抗酸杆菌的阳性检出率较高,差异有统计学意义(P<0.05)。在8000份痰液标本中,液基细胞学涂片法对唾液痰、黏液痰、血痰、脓性痰抗酸杆菌阳性检出率分别为14.52%(108/744)、12.09%(429/3548)、65.49%(334/510)、49.00%(1567/3198),直接涂片法对唾液痰、黏液痰、血痰、脓性痰抗酸杆菌阳性检出率分别为2.96%(22/744)、8.26%(293/3548)、42.35%(216/510)、36.34%(1162/3198)。与唾液痰、黏液痰、脓性痰相比,两种检测方法对血痰抗酸杆菌阳性检出率较高,差异有统计学意义(P<0.05);与直接涂片法相比,液基细胞学涂片法对唾液痰、黏液痰、血痰、脓性痰抗酸杆菌阳性检出率较高,差异有统计学意义(P<0.05)。结论在痰抗酸杆菌检测中应用液基细胞学涂片法,可有效诊断肺结核,为临床诊疗提供依据。

Objective To compare the detection values of direct smear and liquid-based cytology smear in the detection of acid-fast bacilli in sputum.Methods A total of 4000 patients with tuberculosis admitted to Binzhou Central Hospital from May 2018 to May 2019 were selected.One sputum sample at night and one sputum sample at morning were collected from every patients.Finally,8000 specimens were enrolled in the study in total.Direct smear method and liquid-based cytology smear method were used to detect the 8000 specimens.And the positive detection rates of acid-fast bacilli in sputum by two methods were recorded.Results The positive detection rates of acid-fast bacilli in the morning sputum sample by liquid-based cytology smear and direct smear were 30.33%(2426/4000)and 21.55%(1724/4000),respectively,and the positive detection rates of the night sputum samples by the two methods were 22.34%(1787/4000)and 12.40%(992/4000)respectively.Compared with the night sputum samples,the positive detection rates of acid-fast bacilli in the morning sputum samples by two detection methods were higher,and the difference was statistically significant(P<0.05).Compared with direct smear method,the positive rates of acid-fast bacilli in the morning sputum samples and in the night sputum samples detected by liquid-based cytology smear method were higher,and the difference was statistically significant(P<0.05).Among the 8000 specimens,the positive rates of salivary sputum,mucus sputum,blood sputum and purulent sputum detected by liquid-based cytology smear method were 14.52%(108/744),12.09%(429/3548),65.49%(334/510)and 49.00%(1567/3198),respectively,And the positive detection rates of salivary sputum,mucus sputum,blood sputum and purulent sputum detected by direct smear method were 2.96%(22/744),8.26%(293/3548),42.35%(216/510)and 36.34%(1162/3198),respectively.Compared with salivary sputum,mucus sputum and purulent sputum,the positive detection rates of acid-fast bacilli in blood sputum by the two methods were higher,and the difference was statistically significant(P<0.05).Compared with the direct smear method,the positive detection rates of sputum,mucus sputum,blood sputum and purulent sputum by liquid based cytology smear method were higher,and the difference was statistically significant(P<0.05).Conclusions The application of liquid-based cytology smear in the detection of acid-fast bacilli in sputum can effectively diagnose pulmonary tuberculosis and provide a basis for clinical diagnosis and treatment.