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目的:评价一种简便、快速而又经济的L型结核分支杆菌的快速方法及其对涂阴肺结核病的诊断价值。方法:通过选择确诊的200例涂阴肺结核病患者痰液标本分别接种在L型双相培养基、L型液体培养基、L固体培养基上,比较3种培养方法的特点和优劣,并对培养阳性的L型结核分支杆菌的病例进行初复治、有无空洞的比较。结果:L型双相培养基、L型液体培养基(92-3TBL)、L固体培养基(TSA-L)阳性分离率分别为39.0%、37.0%、36.5%,经统计学分析,均无显著性差异(P均>0.05)。阳性结果出现的平均时间分别为15.0±3.2 d、16.0±2.5 d、30.0±5.0 d,L型双相培养基比L固体培养基培养提早15.0 d(P<0.01);与L型液体培养基培养时间两者差异无显著性(P>0.05)。对复治病人的阳性率明显高于初治病人(P<0.01),有空洞者明显高于无空洞者(P<0.01)。结论:L型双相培养基不仅能使L型结核分支杆菌快速生长,而且能达到快速分纯菌株之目的;该法操作简单,结果准确,价格低廉,对提高涂阴肺结核病正确诊断率有重要意义,适合广大基层医疗单位推广使用。
OBJECTIVE: To evaluate a simple, rapid and economical rapid method for detecting Mycobacterium L type L and its diagnostic value on smear-negative pulmonary tuberculosis. Methods: The sputum specimens from 200 patients with smear-negative pulmonary tuberculosis were selected and inoculated on L-type biphasic medium, L-type liquid medium and L solid medium respectively. The characteristics and advantages of the three culture methods were compared. For the culture of positive cases of L type Mycobacterium tuberculosis early retreatment, with or without empty comparison. Results: The positive rates of L-type dual-phase medium, L-type liquid medium (92-3TBL) and L solid medium (TSA-L) were 39.0%, 37.0% and 36.5% respectively. Significant difference (P> 0.05). The positive results were 15.0 ± 3.2 days, 16.0 ± 2.5 days and 30.0 ± 5.0 days, respectively. L-type biphasic medium was 15.0 days earlier than L solid medium (P <0.01) There was no significant difference between the two groups in training time (P> 0.05). The positive rate of retreatment patients was significantly higher than that of the newly diagnosed patients (P <0.01), those with vacuoles were significantly higher than those without cavities (P <0.01). Conclusion: L-type biphasic medium can not only rapidly grow L-form Mycobacterium tuberculosis, but also achieve the purpose of rapidly isolating pure strains. The method has the advantages of simple operation, accurate results and low price, and has the positive effect on improving the correct diagnosis of smear-negative pulmonary tuberculosis Important meaning, suitable for the broad masses of primary medical units to promote use.