肺曲霉病痰液检验诊断的标准化

目的研究利用痰液检验诊断肺曲霉菌病,提高肺曲霉菌病的诊断率。方法将痰液标本收集、显微镜检查、真菌培养标准化,实验室检查痰液中的曲霉菌结果分为协同阳性、生长阳性与培养可疑3个等级,收集279例痰液培养真菌阳性病例进行回顾性分析,判断标准化痰液检验的诊断效果。结果痰液曲霉菌协同阳性与肺曲霉病患者诊断有效率达93.75%,与培养可疑的诊断有效率差异有统计学意义(x2=15.18,P<0.05);痰液曲霉菌检验对曲霉菌球、过敏性支气管肺曲霉菌病和侵袭性肺曲霉菌病诊断的敏感率差异亦有统计学意义(x2=28.45,P<0.05),仅对肺曲菌球敏感度较低。结论肺曲霉病痰液检验诊断的标准化能对肺曲霉菌病进行早期、准确诊断,降低患者死亡率。

Standardization in sputum examination of pulmonary aspergillosis

Objective To investigate early diagnosis and increase the positive rate in pulmonary aspergillosis.Methods The sputum of patiens were collected and examinated by microphone and cultured by standardization methods.Positive result of included and culture positive and probable positive.Effect of diagnosis for standardization in sputum examination of pulmonary aspergillosis was examined by 279 cases with sputum fungal culture which were retrospectively reviewed.Results Diagnostic efficiency of synergistic positive of sputum aspergillus culture for pulmonary aspergillosis was 93.75%.A chi-square test showed that the dfference between synergistic positive and probable positive was statistically significant(x 2 =15.18,P < 0.05).Furthermore,the sensitivity of pulmonary aspergillosis(invasive pulmonary aspergillosis,allergic bronchopulmonary aspergillosis and aspergilloma) determined was statistically significant(x 2 =28.45,P < 0.005).Conclusion Pulmonary aspergillosis can be diagnosed early and correctly by standardization in sputum examination of pulmonary aspergillosis and the danger of death can be decrease.