263例住院肺结核患者痰涂片抗酸杆菌阳性检出分析

目的了解住院肺结核患者痰涂片抗酸杆菌（AFB）阳性检出特征，为肺结核诊断提供可靠依据。方法对263例住院肺结核患者痰标本直接厚涂片AFB检查，并对涂阳患者进行I豳床分析。结果发现涂片阳性肺结核患者95例，阳性率36．1％。其中AFB（±）7例（7．4％）、AFB（1＋）36例（37．9％）、AFB（2＋）20例（21．0％）、AFB（3＋）13例（13．7％）、AFB（4＋）19例（20．0％）。三个痰标本首次涂片阳性率为65．3％（62／95），清晨痰标本阳性检出率为61．8％（84／136），涂阳患者三种不同痰标本和不同送检次数在AFB阳性检出上均有统计学意义（P〈0．01）。与涂阴肺结核比较，涂阳肺结核患者咳嗽、咯血、发热、空洞形成和病灶≥2个肺野等比例分别高达97．9％、41．1％、54．7％、48．4％和82．1％，存在显著性差异（P〈0．05）。结论留取合格痰标本，认真涂片检查，提高痰标本阳性检出率，痰涂片检查符合我国国情，是实施结核病控制项目DOTS策略的关键之一。

Clinical analysis of acid-fast bacilli(+)from 263 pulmonary TB cases

Objective To investigate clinical feature of AFB （ ＋ ） from pulmonary TB and to provide basis for diagnosis of TB. Methods The study conducted AFB examination of direct smear in 263 pulmonary TB cases and clinical analysis of the smear positive TB cases. Results 95 smear positive TB cases were found,with the rate of 36. 1%. Among them：7 had AFB （ ± ） （7. 4% ） ,36 had AFB （1 ＋ ） （37. 9 % ）,20 had AFB （ 2 ＋ ） （21.0 % ）, 13 had AFB （ 3 ＋ ） （ 13.7 % ）, and 19 had AFB （4 ＋ ） （ 20. 0 % ）. The rate of positive examination between initial and re-treatment cases wasn＇t significantly different. The first smear positive was 65.3% （62/95） through three smear tests, the positive rate in the morning was 61.8% （84/136）, three different specimen and the different times of the smear positive cases were significantly different in AFB （ ＋ ）. There was significant difference between the positive and the negative. In the positive TB cases, the rates of cough, emptysis, fever, cavity, focus exceeding two lung lobars were 97. 9%, 41.4%, 54. 7%, 48. 4% and 82. 1% respectively. Conclusion Keeping qualified sputum specimen, the examination of smear staining, strengthening the control of quality and cooperation are important guarantee of raising the positive examination rate. The smear staining is suitable for China and one of keys to DOTS.