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目的:痰菌阳性率是肺结核病控制的一个重要指标,也是工作成效考核的指标之一.根据2017年北京市结核病控制研究所在所建病历210例患者的总体情况,分析痰菌阳性率的影响因素.资料和方法:分析2017年北京市结核病控制研究所在所建病历210例患者的总体情况,从患者来源,是主动体检检出还是有症状就诊后发现;肺部阴影面积,是否有空洞;是否合并其它疾病等等分析.痰检涂片及培养是否有差别.结果:210例患者中,健康体检查出90例,有症状就诊120例.阳性患者111,总阳性率:52.08%.体检检出患者阳性34人,涂片阳性8人,培养阳性29人,阳性率:37.7%.因症就诊患者120人,总体阳性77人,涂片阳性50人,培养阳性66人.阳性率64.17%.健康体检患者阳性率与有症状患者阳性率差异有统计学意义x2=14.37,P=0.00015.涂片阳性与培养阳性患者阳性率差异有统计学意义,x^2=4.624953,P=0.031510.合并肺部空洞50例,其中体检肺部空洞9人,有症状41例.其中有合并症如病毒性肝炎感染、糖尿病、风湿免疫性疾病等18例,只有3例为痰菌阴性,阳性率为94%.在210例患者中,进行细菌DNA(Gxpert)检查16例.确定NTM(非结核分枝杆菌)7例.讨论:痰菌阳性率受很多因素影响,主动体检发现患者,时间窗前移,可引起痰菌阳性率低.培养阳性率高于涂片阳性率.有合并症或有肺部空洞患者阳性率高.结核性胸膜炎归入肺结核管理,也会降低痰菌阳性率.因此应该客观看待痰菌阳性率.并应努力提高痰菌阳性率.,Objective:the positive rate of phlegm is one of the important index in tuberculosis control,and it’s a index of performance appraisal.Analyze the Influence factor of the positive rate of phlegm.Methods:Analyses on the 210 paitients of Beijing reserrch institute for tuberculosis in 2017.paitients who was find because had symptom or by Orientation health cheek;was there any complication,just like cave,diabetes,hepatitides,rheumatic immune disease and others.the difference between sputum smear or phlegm culture.Results:In 210 patients,by Orientation health cheek was 90,the positive rate is 37.7%.the paitients who was find because had symptom was 111,the positive rate is:52.8%.the difference was satistically significant(x^2=14.37,P=0.00015).there were 50 paitients had caves,by Orientation health cheek was 9,who was find because had symptom was 41,the positive rate is 94%,among them,there’s 18 had complications,such as diabetes,hepatitides,rheumatic immune disease.Sputum smear positive was 58,by Orientation health cheek was 8,phlegm culcture positive was 95,by Orientation health cheek was 29.the difference was satistically significant(x^2=4.624953,P=0.031510).Conclusion:the positive rate is influenced by a lot of factors:Take the initiative to find paitients will reduce The positive rate,who had caves,and other,such as diabetes,hepatitides,rheumatic immune disease The positive rate would abave the average.Sputum smear positive rate was lower than phlegm culcture positive.