矽肺结核及矽肺患者结核分支杆菌L型致病情况研究

目的 探讨研究矽肺结核及矽肺患者结核分支杆菌L型致病情况的价值。方法 对矽肺结核组和矽肺组患者，分别进行痰结核分支杆菌和痰结发支杆菌L型培养，并对结果进行对照观察。结果 矽肺结核组60例痰结核分支杆菌培养阳性6例，阳性率10％（同时出现结核分支杆菌L型培养阳性5例，占83％）；痰结核分支杆菌L型培养阳性28例（其中I期矽肺结核L型菌检出率为33％、Ⅱ期为7％、Ⅲ期100％），阳性率47％（P＜0．01）矽肺组30例无一例结核分支杆菌阳性，结核分支杆菌L型阳性3例，占10％。结论 结核分支杆菌L型培养方便快速，能提高结核分支杆菌的检出率，对矽肺结核的早期诊断及减少矽肺结核复发的漏、误诊有肯定的价值、随着矽肺期别的上升，结核分支杆菌L型的检出率明显增高。

Mycobacterium tuberculosis L forms in patients with pulmonary silicotuberculosis and silicosis

OBJECTIVE: To evaluate significance of Mycobacterium tuberculosis L forms in pathogenesis of silicotuberculosis and silicosis. METHODS: Sputum culture for Mycobacterium tuberculosis and its L forms was conducted from both silicotuberculosis and silicosis groups, and the results were compared. RESULTS: Among 60 silicotuberculosis patients, 6 (10%) were sputum Mycobacterium tuberculosis culture positive, of which 5 (83%) were Mycobacterium tuberculosis L forms culture positive; 28 were sputum Mycobacterium tuberculosis L forms culture positive (positive rates in the patients with silicosis stage I, stage II, stage III were 33%, 67%, 100% respectively), with a positive rate of 47%, and a significant difference was found comparing with the frequency of detecting Mycobacterium tuberculosis (P < 0.01). All of the 30 cases with silicosis were Mycobacterium tuberculosis culture negative, however, 3 of them were sputum Mycobacterium tuberculosis L forms culture positive, accounting for 10 percent. CONCLUSIONS: Sputum culture for Mycobacterium tuberculosis L forms is a convenient and rapid way to improve the detection rate of Mycobacterium tuberculosis, with a positive value in early diagnosis of silicotuberculosis by reducing misdiagnosis and underdiagnosis of this disease. Detection rate of Mycobacterium tuberculosis L forms significantly increases with deterioration of silicosis.