Malekmohammad Majid, Marjani Majid, Tabarsi Payam, Baghaei Parvaneh, Sadr Zahra, Naghan Parisa Adimi, Mansouri Davoud, Masjedi Mohammad Reza, Velayati Ali Akbar
Clinical Tuberculosis and Epidemiology Research Centre, National Research Institute of Tuberculosis and Lung Disease, Masih Daneshvari Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Scand J Infect Dis. 2012 May;44(5):369-73. doi: 10.3109/00365548.2011.643820.
The early definitive diagnosis of pulmonary tuberculosis (TB) is important for control of the disease in the community. We performed this study to evaluate the additional gain of post-bronchoscopy sputum in the diagnosis of pulmonary TB.
Bronchoscopy and bronchoalveolar lavage were performed for 126 patients suspected of pulmonary TB who either had 3 negative sputum smears for acid-fast bacilli or could not expectorate. After bronchoscopy the patients were asked to give sputum samples for 3 consecutive days. All of the obtained specimens were investigated for Mycobacterium tuberculosis by smear and culture.
Pulmonary TB was confirmed in 56 patients. Among all confirmed cases, the sensitivity of bronchoalveolar lavage smear was 57.1% (32 of 56), sensitivity of post-bronchoscopy smear was 76.7% (43 of 56), and the yield of a combination of the 2 methods was 83.9% (47 of 56). Results of post-bronchoscopy sputum smears were not significantly related to sex, age, human immunodeficiency virus (HIV) infection, presence of cavitary lesions on chest X-ray, or the ability to expectorate before bronchoscopy (p > 0.05).
Evaluation of post-bronchoscopy sputum smears is helpful for earlier diagnosis of pulmonary TB and is an inexpensive and accessible assay.
肺结核（TB）的早期明确诊断对于社区疾病控制至关重要。我们开展这项研究以评估支气管镜检查后痰液在肺结核诊断中的额外价值。
对126例疑似肺结核患者进行支气管镜检查和支气管肺泡灌洗，这些患者痰涂片抗酸杆菌检查3次均为阴性或无法咳痰。支气管镜检查后，要求患者连续3天提供痰标本。对所有获取的标本进行结核分枝杆菌涂片和培养检查。
56例患者确诊为肺结核。在所有确诊病例中，支气管肺泡灌洗涂片敏感性为57.1%（56例中的32例），支气管镜检查后涂片敏感性为76.7%（56例中的43例），两种方法联合的检出率为83.9%（56例中的47例）。支气管镜检查后痰涂片结果与性别、年龄、人类免疫缺陷病毒（HIV）感染、胸部X线有空洞性病变或支气管镜检查前咳痰能力均无显著相关性（p>0.05）。
评估支气管镜检查后痰涂片有助于早期诊断肺结核，是一种廉价且可及的检测方法。
