摘要
目的 探讨肺结核患者结核分枝杆菌L型的检测及其临床意义。方法 对 12 4例活动性肺结核和 2 2例非活动性肺结核患者 ,分别作痰抗酸染色涂片、改良罗氏培养、BACTEC 960培养和结核分枝杆菌L型培养。结果 痰结核分枝杆菌L型培养阳性率显著高于改良罗氏培养 ,差异有显著性 (χ2 =4.6873 ,P <0 .0 5 ) ,也高于抗酸染色涂片和BACTEC 960培养 ,但差异无显著性 (P >0 .0 5 )。活动性肺结核患者L型培养阳性率为60 .48% ,显著高于非活动性肺结核患者 (χ2 =19.85 65 ,P <0 .0 0 1)。病程越长 ,痰结核分枝杆菌L型阳性率越高 ,但仅病程 >1年者与 <1个月者之间差异有显著性 (P <0 .0 5 )。复治病例L型培养阳性率显著高于初治病例 (χ2 =4.0 5 78,P <0 .0 5 )。有空洞患者L型培养阳性率为 71.19% ,显著高于无空洞患者 (χ2 =5 .3 941,P <0 .0 5 )。耐药和耐多药患者L型培养阳性率均显著高于敏感患者 (P <0 .0 5 )。化疗开始时痰结核分枝杆菌L型阳性者 ,化疗 6个月末痰菌阴转率显著低于L型阴性者 (χ2 =3 .913 8,P <0 .0 5 )。结论 结核分枝杆菌L型培养可提高结核分枝杆菌的阳性检出率 ,对结核病的早期、快速诊断具有重要价值。结核分枝杆菌L型感染X线表现特点为干酪样病变和空洞多。结核分枝杆菌L型耐药率高 ,临?
Objective To investigate the clinical significance of L form of mycobacterium tuberculosis in patients with pulmonary tuberculosis. Methods Acid fast sputum smear, L J culture, bacteria culture and L form culture were conducted in 124 cases of active tuberculosis, 22 inactive tuberculosis, and the results were compared. Results Among the 124 active tuberculosis patients, the positive culture rate of L form mycobacterium tuberculosis was 60.48%, higher than that of L J culture( χ 2=4.6873, P <0.05);and also higher than that of acid fast smear and sputum bactec culture, but the differences were not significant( P >0.05). The positive rate of L form culture in active tuberculosis group was higher than that of inactive tuberculosis group( χ 2=19.8565, P <0.001).The longer the course of the disease was, the higher the positive rate of L form culture, but there was only a significant difference found between those longer than one year and those less than one month ( P <0.05). The positive rate of L form culture in the retreated patients was higher than those newly arose( χ 2=4.0578, P <0.05). The positive rate of L form culture in these with cavity was 71.19%, significantly higher than those without ( χ 2=5.3941, P <0.05). The positive rates of L form culture in the drug resistant group and multi drug resistant group were higher than those of the drug sensitive group( P <0.05). After 6 months' antituberculosis treatments, the negative conversion rates of sputum smear were significantly lower in the positive L form culture patients than in the negative ones( χ 2=3.9138, P < 0.05). Conclusion Sputum culture for L form of mycobacterium tuberculosis can raise the detection rate of mycobacterium tuberculosis and help early rapid diagnosis. The infection caused by L form mycobacterium tuberculosis is characterised by frequent presence of caseous lesions and cavitation in the chest film, and high drug resistance rate with poor therapeutic response, is being an important cause of retreated and refractory tuberculosis.
出处
《上海医学》
CAS
CSCD
北大核心
2002年第9期535-538,共4页
Shanghai Medical Journal
关键词
肺结核
结核分枝杆菌
L型菌
痰检
微生物检测
Tuberculosis, pulmonary
Mycobacterium tuberculosis
Bacterial L forms
