纤支镜灌洗液的结核分支杆菌快速培养对不典型肺结核的诊断价值

Diagnostic value of rapid culture for Mycobacterium tuberculosis in BALF in atypical pulmonary tuberculosis

目的 评价纤维支气管镜 (以下简称纤支镜 )支气管肺泡灌洗液 (BALF)的结核分支杆菌快速培养对不典型肺结核的诊断价值。方法 选无痰或痰菌阴性的不典型肺结核患者 4 9例行纤支镜检查 ,进行活检、刷检、BALF经BBLMGIT分支杆菌快速培养查结核杆菌。结果 4 9例经纤支镜刷检、BALF快速培养结核分支杆菌检出率分别是 6 7.4 %、83.7% ,其中 15例经纤支镜肺活检 ,10例病理证实为结核肉芽肿 ,检出率为 6 6 .7%。结论 纤支镜对无痰或痰菌阴性下BALF行结核分支杆菌快培对不典型肺结核具有较高的诊断价值 ,快速 ,阳性率较高。根据镜下所见采用不同的取材方法可望提高诊断率。

Objective To evaluate the diagnostic significance of rapid culture for Mycobacterium tuberculosis in bronchoalveolar lavage fluid (BALF) for atypical pulmonary tuberculosis.Methods Bronchial brushing,and rapid culture for Mycobacterium tuberculosis were performed for 49 cases with atypical pulmonary tuberculosis who had no sputum or negative sputum acid-fast staining,of them 15 cases underwent transbronchial lung biopsy.Results Of the 49 cases,67.4%(33/49) were confirmed by bronchial brushing,83.7% (42/49) were confirmed by rapid culture for Mycobacterium tuberculosis in BALF.Among the 15 cases who underwent transbronchial lung biopsy,pulmonary tuberculosis was confirmed in 10 cases (66.7%).Conclusion Rapid culture for Mycobacterium tuberculosis in BALF is of significant value for the diagnosis of atypical pulmonary tuberculosis with no sputum or negative sputum acid-fast staining.