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中国防痨杂志 ›› 2004, Vol. 26 ›› Issue (2): 107-109.

• 论著 • 上一篇    下一篇

结核分枝杆菌L型检测的临床意义

吴风霞1;李慧灵1;王鑫君1;   

  1. 1.青岛市胸科医院 青岛 266012;
  • 出版日期:2004-02-10 发布日期:2004-11-03

Clinical significance of the examination to MTB-L

Wu Fengxia,Li Huiling,Wang Xinjun.   

  1. Qingdao Chest Hospital,Q ingdao 266043
  • Online:2004-02-10 Published:2004-11-03

摘要: 目的 研究结核分枝杆菌L型(MTB L)检测的临床意义。方法 结核病 314例留痰 312份,前列腺液 1份,精液 1份,标本经消化调整PH值后,3800转 分离心沉淀 30分钟,取沉淀物接种92 TB L型培养基,进行MTB L培养,同时常规MTB培养对照。进行 (1)初复治肺结核、肺外结核、肺结核治愈者标本MTB、MTB L培养,阳性检出率统计。 (2)观察初治肺结核患者痰MTB L阳性与因症就诊时间关系。 (3)观察复治结核病MTB L阳性检出率与既往第一线用药品种数量关系。结果 314例MTB及MTB L均阳性的阳性检出率为 424%,MTB L阳性检出率为 28 7%,初治MTB L阳性者占菌阳总数的 64.8% (5991),并发现初治MTB L发生与就诊时间有关,超过 1个月与不超过 1个月阳性检出率相比差异有显著性 (P<0.05)。复治MTB L阳性检出率占复治菌阳的72.50% (29 40),并与应用第一线抗结核药物品种数量有关,超过 4种药 3月以上与 1~3种药 3月以上相比,差异非常显著 (P<0.01)。结论 MTB L检测对结核病诊断、判断活动性、考核疗效及指导临床治疗,尤其痰MTB阴性者治疗,有重要临床意义。初、复治患者及时就诊,正规治疗,是减少MTB L的形成的关键。

关键词: 分枝杆菌结核, L型菌, 检测, 阳性检出率

Abstract: Objective To investigate the clinical significance of the examination to Mycobacterium tuberculosis L type (MTB L). Methods There were 314 specimens from 314 cases with tuberculos is: 312 portions of sputum, 1 portion of prostatic fluid and 1 portion of semen. The specimens were digested, adjusted PH and then centrifugalized for 30 minutes with 3800 turns per minute. Picked the sediments and inoculated them to 92 TB L and common TB culture bases as the control.The following Results were anal ysised:(1) The positive ratio of MTB L and MTB culture in initial and retreatment cases, extra pulmonary cases and cured cases. (2)The relationship between positive rate of sputum MTB L culture and the duration that patients taking clini cal consultation and the onset of illness of initial pulmonary tuberculosis cases. (3)The relationship between positive rate of sputum MTB L culture and the variety and quantity of the first line TB drugs used before of retreatment pu lmonary tuberculosis cases. Results In 314 cases,the co positive rate of MTB and MTB L culture was 42.4%.The single positive rate of MTB L culture was 28.7%.The case with positive result of MTB L culture in initial cases occupied 64.8% of the total positive cases (59/91) and related with the durati on of clinical consultation. There was significant difference of the positive rates between that of cases who taking clinical consultation exceeding one month and less than one month (P<0.05). In retreatment cases,the cases with positive result of MTB L culture occupied 72.5% in total retreatment positive cases (29/40) and related to the variety and quantity of the first line TB drugs used before. There was significant difference of positive ratio between 4 drugs and 13 drugs used for more than 3 months (P<0.01). Conclusions There was great clinical significance of the examin ation to MTB L for diagnosing,judging the activity,assesment the treatment effe ction and guiding the clinical treatment, especially to MTB negative cases.It was important for initial and retreatment patients that they should make clinical consultation timely and be treated regularly to reduce the forming of MTB L.

Key words: Mycobacterium tuberculosis, L type, Examination, Positive ratio