Kurashima A, Takano T
Department of Respiratory Diseases, National Tokyo Chest Hospital, Japan.
Kekkaku. 1992 Dec;67(12):771-4.
From 1981 to 1991, 5,572 patients underwent bronchoscopic examination, in this series 3,754 patient's samples were sent for determination of mycobacterial isolation. In the 506 samples, mycobacterial bacilli were detected with smear or culture. In the low tuberculous incidence area like northern part of America, many reporters supported the opinion that routine bronchial aspirate detection for tuberculosis was not cost-effective. Inversely, in the high tuberculous incidence area like Hong Kong, M. lp et al. claimed the usefulness of routine bronchial aspirate examination for mycobacterial bacilli. Japan was regarded as moderate tuberculous incidence area. We review a ten-year experience with fiberoptic bronchoscopy for mycobacterial isolation. Our results suggest that in an area with a moderate prevalence of tuberculosis, bronchoscopic examination for mycobacterial disease is useful in the selected hospitals for the selected cases. In Japan, the smear positive prevalence has been on the increase from 1982. We estimate that the Japanese popularization of fiberoptic bronchoscopy may influence a part of the Japanese epidemic statistical analysis of mycobacteriosis.
1981年至1991年期间，5572例患者接受了支气管镜检查，在该系列中，3754例患者的样本被送去进行分枝杆菌分离测定。在506份样本中，通过涂片或培养检测到了分枝杆菌。在结核病低发地区，如美国北部，许多报告者支持这样的观点，即常规支气管吸出物检测结核病不具有成本效益。相反，在结核病高发地区，如香港，M. lp等人声称常规支气管吸出物检查对分枝杆菌的有用性。日本被视为结核病发病率中等的地区。我们回顾了十年间使用纤维支气管镜进行分枝杆菌分离的经验。我们的结果表明，在结核病患病率中等的地区，在选定的医院针对选定的病例进行支气管镜检查以诊断分枝杆菌病是有用的。在日本，涂片阳性患病率自1982年以来一直在上升。我们估计，日本纤维支气管镜的普及可能会影响日本分枝杆菌病流行统计分析的一部分。
