Yilmaz Adnan, Bayram Selvi Ummühan, Damadoğlu Ebru, Güngör Sinem, Partal Mualla, Akkaya Esen, Karagöz Turan
Süreyyapaşa Chest Diseases and Thoracic Surgery Training and Investigation Hospital, Istanbul, Turkey.
Tuberk Toraks. 2008;56(2):158-62.
The aim of this study was to assess the value of examining multiple sputum specimens in the diagnosis of pulmonary tuberculosis (PTB). We analyzed sputum smear and culture results of patients diagnosed with culture-proven PTB during 2002. In 1027 patients, the diagnosis was established by detection of Mycobacterium tuberculosis bacilli in sputum samples. The number of sputum specimens submitted to laboratory was one in 634 cases, two in 167 cases, three in 186 cases and more than three in 48 cases. 760 (74%) cases had positive smear examination result. The first sputum smear examination was positive in 82.3% of smear positive cases. Either the first or the second sputum was diagnostic in 94.9% of these cases. Smear examination of third sputum revealed 4.2% additional diagnostic yield. In 863 (84%) cases, culture examination of the first sputum was positive. The second and the third sputum culture examinations revealed additional diagnostic yield of 11% and 4.5%, respectively. Percent 95 of culture-proven cases were diagnosed with the first two sputum cultures. In conclusion the majority of PTB cases can be diagnosed with the examination of two sputum specimens. Three or more sputum specimens submitted obtain a small additional diagnostic yield.
本研究的目的是评估检查多个痰标本在肺结核（PTB）诊断中的价值。我们分析了2002年期间经培养证实为PTB的患者的痰涂片和培养结果。在1027例患者中，通过在痰标本中检测到结核分枝杆菌确诊。提交给实验室的痰标本数量为：634例为1份，167例为2份，186例为3份，48例超过3份。760例（74%）涂片检查结果为阳性。在涂片阳性病例中，首次痰涂片检查阳性的占82.3%。这些病例中，94.9%的病例首次或第二次痰标本具有诊断价值。第三次痰涂片检查的诊断率提高了4.2%。863例（84%）患者首次痰培养检查呈阳性。第二次和第三次痰培养检查的诊断率分别提高了11%和4.5%。95%经培养证实的病例通过前两次痰培养得以诊断。总之，大多数PTB病例通过检查两份痰标本即可诊断。提交三份或更多痰标本获得的额外诊断率较小。
