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[目的]探讨肺结核合并非结核分枝杆菌肺病的临床最佳检测方法。[方法]收集福州肺科医院住院或门诊肺结核患者痰标本进行BACTEC960培养,对阳性培养液行涂片抗酸染色检查外,续行胶体金试验、变色液体培养基系统试验、对硝基苯甲酸(PNB)和噻吩-2-羧酸肼(TCH)试验作初筛鉴定,同时行结核感染T细胞斑点实验(T-SPOT.TB)检测。[结果]258份BACTEC 960阳性培养液行3种初筛鉴定方法结果类似(2=3.40,P>0.05),结核分枝杆菌胶体金试验因其快速简单的操作而显优势。BACTEC 960培阳肺结核患者T-SPOT.TB检测阳性率为92.1%(152/165);40例非结核分枝杆菌肺病患者均呈阴性;15例肺结核合并非结核分枝杆菌肺病患者均呈阳性。[结论]BACTEC 960培养阳性→涂片抗酸染色→结核分枝杆菌胶体金试验→T-SPOT.TB检测,可用于结核病的快速诊断,且为最佳检测路线图,能早期诊断肺结核合并非结核分枝杆菌肺病。
[Objective] To explore the best clinical detection method of pulmonary tuberculosis combined with non-tuberculosis mycobacterium tuberculosis. [Method] The sputum samples of hospitalized or outpatient pulmonary tuberculosis patients in Fuzhou Pulmonary Hospital were collected and cultured in BACTEC960. The positive culture medium was smear acid-fast staining test, colloidal gold test, system test of discoloration liquid medium, (PNB) and thiophene-2-carboxylic acid hydrazine (TCH) were used for primary screening and T-SPOT.TB detection. [Results] The results of three primary screening tests in 258 BACTEC 960 positive culture medium were similar (2 = 3.40, P> 0.05). The Mycobacterium tuberculosis colloidal gold test was superior because of its quick and easy operation. The positive rate of T-SPOT.TB was 92.1% (152/165) in BACTEC 960 Pei-Yang pulmonary tuberculosis patients; all 40 patients with non-tuberculous mycobacterium tuberculosis were negative; 15 patients with tuberculosis and non-tuberculous mycobacterium tuberculosis were positive . [Conclusion] BACTEC 960 culture positive smear antacid staining Mycobacterium tuberculosis colloidal gold test T-SPOT.TB test can be used for rapid diagnosis of tuberculosis, and for the best detection of the road map can be an early diagnosis of pulmonary tuberculosis merger Mycobacterium tuberculosis lung disease.