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1985年我所对河南省17个地市45个结核病流调点的可疑肺结核1104例进行抗酸杆菌培养,初步分离出抗酸杆菌145株.除11株保存不善未能鉴定外,下佘134株均作了分枝杆菌菌型鉴定。鉴定结果:人型结核杆菌119株,占总数的87.31%;牛型结核杆菌9株,占6.72%;非典型分枝杆菌(AM)8株,占5.97%。AM 分布广泛,类型繁多,对人致病者就有15种之多,专家鉴定出的8株也有7个类型。凡肺部检查发现病变,痰涂片或培养找出抗酸杆菌者,并非都是结核菌感染,而应想到与结核菌形态相似的 AM 感染的可能,但由于 AM 肺病酷似肺结核,仅从临床表现,X 线所见,涂片检查以及病理切片均难以将二者区别。因此,目前 AM 肺病的临床诊断仍主要依靠菌型鉴定分类.我所综合国内外各家意见,关于肺 AM 病的诊断标准哲定为:①短期内痰标本培养频回三次,发现同一类 AM:②肺部有阳性 X 线发现;薄壁
In 1985, I conducted 1104 cases of suspicious pulmonary tuberculosis in 45 TB epidemics in 17 cities of Henan Province for acid-fast bacilli cultivation, initially isolating acid-fast bacilli 145. Except for 11 strains that were not properly preserved, Mycobacterium strains were identified strains. Identification results: 119 strains of Mycobacterium tuberculosis, accounting for 87.31% of the total; 9 strains of Mycobacterium bovis, accounting for 6.72%; 8 strains of atypical mycobacteria (5.97%). A wide range of AM, a wide range of types, there are as many as 15 kinds of human diseases, experts identified eight strains also have seven types. Where the lung examination found lesions, sputum smear or culture to identify acid-fast bacilli, not all are infected with tuberculosis, but should think of the form of TB infection and the possibility of AM infection, but as pulmonary tuberculosis resembles pulmonary tuberculosis, only from the clinical Performance, X-ray findings, smears and pathological sections are difficult to distinguish the two. Therefore, the current clinical diagnosis of AM lung disease is still mainly rely on mycobacterial identification classification.I comprehensive domestic and foreign opinions on the diagnostic criteria for pulmonary AM disease philosophy as follows: ① sputum specimens in the short term culture back to three times and found the same type of AM : ② positive pulmonary X-ray findings; thin-walled