支气管镜在菌阴肺结核诊断中应用价值

Application value of bronchoscopy in diagnosis of bacterial negative pulmonary tuberculosis

目的探讨电子支气管镜检查在菌阴肺结核诊断中应用价值。方法选取2018年6月至2020年12月大同市第四人民医院862例菌阴肺结核患者作为研究对象,所有对象均进行结核分枝杆菌相关检测,对比菌阴肺结核患者两种标本结核分枝杆菌相关检查的阳性率。结果镜检前后痰液及冲洗液标本抗酸染色阳性率三者之间比较(P<0.05);冲洗液BD-960快速培养、罗氏培养及药敏、PCR-TB-DNA、X-pert及Hain检测阳性率分别与镜检前传统痰涂片抗酸杆菌阳性率比较(P<0.05);支气管冲洗液抗酸染色联合BD-960快速培养、PCR-TB-DNA、X-pert、Hain及罗氏培养阳性率分别与镜检前后传统痰涂片抗酸杆菌阳性率比较(P<0.05)。支气管冲洗液抗酸染色联合BD-960快速培养、罗氏培养阳性率低于支气管冲洗液PCR-TB-DNA、X-pert、Hain阳性率(P<0.05)。结论采用电子支气管镜肺泡冲洗检查,联合抗酸染色,联合BD-960快速培养、PCR-TB-DNA、X-pert、Hain及罗氏培养检测能够明显提升菌阴肺结核患者的阳性检出率。

Objective To explore the value of electronic bronchoscopy in diagnosis of bacteria-negative pulmonary tuberculosis.Methods 862 patients with negative pulmonary tuberculosis from the Fourth People’s Hospital of Datong from June 2018 to December 2020 were selected as the research objects.All subjects were tested for mycobacterium tuberculosis,and the positive rate of bacillus test in two specimens of TB patients with negative pulmonary tuberculosis were compared.Results There was significant difference in the positive rate of acid-fast staining in sputum and washing fluid samples before and after microscopy(P<0.05).The positive rate in washing fluid BD-960 rapid culture,Roche culture and drug sensitivity,PCR-TB-DNA,X-pert and Hain test showed significant difference with traditional sputum smear before microscopy(P<0.05).The positive rate of acid-fast staining of bronchial lavage fluid combined with BD-960 rapid culture,PCR-TB-DNA,X-pert,Hain and Roche culture showed significant difference with traditional sputum smear before and after microscopy(P<0.05).The positive rate of acid-fast staining of bronchial lavage fluid combined with BD-960 rapid culture and Roche culture was lower than that of PCR-TB-DNA,X-pert,and Hain(P<0.05).Conclusion The use of electronic bronchoscope alveolar washing examination combined with acid-fast staining BD-960 rapid culture,PCR-TB-DNA,X-pert,Hain and Roche culture detection can significantly increase the positive detection rate of negative pulmonary tuberculosis patients.