经电子支气管镜保护性毛刷采样术与痰培养在慢性阻塞性肺疾病急性加重期合并肺部感染中的诊断准确率

Diagnostic Accuracy of Protective Brush Sampling and Sputum Culture through Fiberbronchoscopy in Acute Exacerbation of Chronic Obstructive Pulmonary Disease Complicated with Pulmonary Infection

目的:探讨经电子支气管镜保护性毛刷采样术(PSB)与痰培养在慢性阻塞性肺疾病急性加重期(AECOPD)合并肺部感染中的诊断准确率。方法:选取2022年2月—2023年7月在西宁市第三人民医院收治的疑似AECOPD合并肺部感染患者80例作为研究对象,均进行PSB及口痰取样痰培养。比较两种取样方式标本的合格率,分析两种取样方式的诊断符合率及与病理诊断结果的一致性。结果:PSB标本合格率高于痰培养,差异有统计学意义(P=0.001);PSB与病理结果的诊断符合率高于痰培养,差异有统计学意义(P=0.024);根据Kappa检验,痰培养与病理诊断结果的一致性为0.500,为中等一致性,PSB与病理诊断结果的一致性为0.750,表示较好一致性。结论:PSB在AECOPD合并肺部感染诊断中具有较高的准确率和可靠性,优于痰培养,可作为一种有效的微生物学检测方法。

Objective:To investigate the diagnostic accuracy of protective brush sampling(PSB)and sputum culture in acute exacerbation of chronic obstructive pulmonary disease(AECOPD)with pulmonary infection.Methods:A total of eighty patients with suspected AECOPD combined with pulmonary infection admitted to Xining Third People's Hospital from February 2022 to July 2023 were selected as the study objects.PSB and sputum sampling and sputum culture were performed on all patients.The qualified rate of two sampling methods was compared,and the diagnostic coincidence rate and the consistency with pathological diagnosis were analyzed.Results:The qualified rate of PSB was higher than that of sputum culture,the difference was statistically significant(P=0.001);The diagnosis coincidence rate of PSB and pathological results was higher than that of sputum culture,the difference was statistically significant(P=0.024);According to Kappa test,the consistency between sputum culture and pathological diagnosis results was 0.500,indicating equal consistency,and the consistency between PSB and pathological diagnosis results was 0.750,indicating good consistency.Conclusion:PSB has high accuracy and reliability in the diagnosis of AECOPD combined with pulmonary infection,which is better than sputum culture,and can be used as an effective microbiological detection method.