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目的探讨纤维支气管镜(简称纤支镜)联合刷检、活检及支气管肺泡灌洗液(BALF)噬菌体裂解法对痰菌阴性肺结核(SNPTB)的诊断价值。方法纳入SNPTB患者100例,随机分为实验组与对照组,每组50例。实验组予纤支镜刷检联合刷检、活检及BALF噬菌体裂解法检查,以任意一项阳性为检测阳性;对照组予传统痰抗酸染色、聚合酶链反应(PCR)、结核菌素试验(PPD)、血结核抗体检测,以任意一项阳性为检测阳性。对比两组诊断效果,并对比实验组三种检测方案独立阳性率。结果实验组阳性检出率94.0%,明显高于对照组68.0%,差异具有统计学意义(P<0.05);实验组中刷检阳性率66.0%、活检阳性率61.9%,均明显低于BALF噬菌体裂解法阳性检出率92.0%,差异具有统计学意义(P<0.0125)。结论多种纤支镜检测方案联合,对SNPTB的诊断效果极佳;这些检测方案中,又以BALF噬菌体裂解法诊断价值最高。
Objective To investigate the diagnostic value of bronchoscopy combined with brushing, biopsy and bronchoalveolar lavage fluid (BALF) phage lysis in the diagnosis of sputum negative pulmonary tuberculosis (SNPTB). Methods 100 patients with SNPTB were randomly divided into experimental group and control group, 50 cases in each group. In the experimental group, bronchoscopy combined with brushing, biopsy and BALF phage lysis were used to detect the positive results. The control group was given traditional sputum acid-fast staining, polymerase chain reaction (PCR), tuberculin test (PPD), blood test for tuberculosis antibody, positive test for any positive. The diagnostic results of the two groups were compared, and the independent positive rates of the three test groups were compared. Results The positive rate of the test group was 94.0%, which was significantly higher than that of the control group (68.0%, P <0.05). The positive rate of brush test in the experimental group was 66.0% and the positive rate of biopsy was 61.9% The positive rate of phage lysis was 92.0%, the difference was statistically significant (P <0.0125). Conclusion The combination of multiple bronchoscopy and bronchoscopy is excellent for the diagnosis of SNPTB. In these tests, BALF phage lysis is the most valuable method.