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支气管肺泡灌洗液多指标联合检测对不典型肺结核的诊断价值探讨
引用本文:顾红艳,戴建忠,施军卫,袁瑛,陈永权,秦志华,顾德林. 支气管肺泡灌洗液多指标联合检测对不典型肺结核的诊断价值探讨[J]. 临床肺科杂志, 2008, 13(9): 1149-1150
作者姓名:顾红艳  戴建忠  施军卫  袁瑛  陈永权  秦志华  顾德林
作者单位:江苏省南通市肺科医院,226003;江苏省南通市肺科医院,226003;江苏省南通市肺科医院,226003;江苏省南通市肺科医院,226003;江苏省南通市肺科医院,226003;江苏省南通市肺科医院,226003;江苏省南通市肺科医院,226003
摘    要:目的探讨支气管肺泡灌洗液(BALF)多指标联合检测对不典型肺结核的诊断价值。方法56例不典型肺结核患者治疗前均进行支气管镜检查,行支气管刷检涂片法、镜检后痰涂片法、BALF涂片法以及联合进行BALF涂片、BALF聚合酶链反应(BALF-PCR)、BALF结核抗原(BALF-TBAG)和BALF腺苷脱氨酶(BALF-ADA)四项指标检测方法,分析不同的检测方法对不典型肺结核诊断的阳性率。结果56例患者行支气管刷检涂片法、镜检后痰涂片法、BALF涂片法的阳性率分别为39.2%,46.4%,75.0%,联合进行BALF涂片、BALF-PCR、BALF-TBAG和BALF-ADA四项指标检测的阳性率为92.8%,与前三种检测方法相比,差异有显著性(P〈0.05)。结论BALF多指标联合检测对不典型肺结核具有较高的诊断价值,特异性高,快速,大大缩短诊断时间,可以明显提高诊断阳性率,是一项较好的组合方式。

关 键 词:支气管肺泡灌洗液  支气管多指标联合检测  不典型肺结核  聚合酶链反应  诊断

Diagnostic value of bronchoscopy in BALF in atypical pulmonary tuberculosis
Affiliation:GU Hongyan;DAI Jianzhong;SHI Junwei;et al( Department of Respiratory Diseases;Nantong Pulmonary Hospital;Jiangshu 226003;China)
Abstract:Objective To evaluate the diagnostic significance of bronchoscopy in bronchoalveolar lavage fluid (BALF) in treating atypical pulmonary tuberculosis.Methods Bronchial brushing and phlegm test after bronchoscopy in BALF were performed in all 56 patients,including BALF smear,BALF-PCR,BALF-TBAG and BALF-ADA.Results Of the 56 cases,39.2% (22/56) were confirmed by bronchial brushing,46.4% (26/56) were confirmed by phlegm test after bronchoscopy,75.0% (46/56) were confirmed by bronchs alveolus lavage and 92.8%(52/56) were confirmed by bronschoscopy in BALF.Conclusion Bronchoscopy in BALF is of significant value in the diagnosis of atypical pulmonary tuberculosis.BALF smear,BALF-PCR,BALF-TBAG and BALF-ADA are supplementary for improving the diagnosis rate.
Keywords:bronchoalveolar lavage fluid  bronchoscopy  atypical pulmonary tuberculosis  polymerase chain reaction  diagnosis
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