痰菌阴性L型菌阳性的60例肺结核病人的临床分析

CLINICAL OBSERVATION ON 60 CASES OF PULMONARY TUBERCULOSIS WITH SPUTUM M. TUBERCULOSIS NEGATIVE AND L-FORM OF M. TUBERCULOSIS POSITIVE

为了解痰菌阴性(- )L型菌阳性 (+)肺结核病人的临床表现和特点 ,对 2 0 4例痰涂片及培养均阴性的肺结核病人做痰标本L型菌分离培养 ,依据L型菌分离培养的结果分为 6 0例L型菌 (+)组及 14 4例L型菌 (- )组 ,并将其主要症状、X线表现及治疗结果进行比较。结果 2 0 4例痰菌阴性肺结核L型菌检出率为 2 9 4 % ,L型菌 (+)组的干酪病灶和干酪空洞多于L型菌 (- )组 ,L型菌 (- )组病灶的显著吸率 (病灶吸收≥5 0 % )高于L型菌 (+)组。作者认为 ,L型菌的存在提示病变有活动性 ,结核病的治疗必须坚持合理的全程化疗 。

To study the clinical feature of pulmonary tuberculosis with sputum M. tuberculosis negative and L form of M. tuberculosis positive, the sputum of 204 patients with pulmonary tuberculosis with negative smear and culture results was cultured for L form of M. tuberculosis. A comparative study of major clinical manifestations, X ray, and therapeutic effect was carried out in 60 cases of L form positive and 144 cases of L form negative pulmonary tuberculosis. The detection rate of L form positive in patients with pulmonary tuberculosis was 29 4%. The incidence of caseous lesion and cavitation in the L form positive patients was higher than those with L form negative, and the incidence of focal absorption was higher in L form negative patients than those with L form positive. The existence of L form of M. tuberculosis suggested activity of the tuberculous lesion. The treatment of pulmonary tuberculosis must be persisted with a reasonable regimen with whole therapeutic period until L form of M. tuberculosis is eliminated from sputum.