Incheon branch, Korean National Tuberculosis Association, Incheon, South Korea.
BMC Infect Dis. 2012 Aug 1;12:172. doi: 10.1186/1471-2334-12-172.
Although checking specimen quality upon sputum collection for acid-fast smear of suspected tuberculosis (TB) cases is recommended, this procedure is based on expert opinion. The purpose of this study was to elucidate the impact of sputum gross appearance and volume on smear positivity among patients with suspected pulmonary TB, according to sex.
From November 2010 through June 2011, we enrolled consecutive patients suspected to have active pulmonary TB. The association of sputum gross appearance and volume with smear positivity, along with other variables possibly affecting smear positivity such as symptoms, disease extent, and cavity on chest radiograph, were investigated.
Among 2,439 patients undergoing TB examination, 170 (113 men, 57 women) with active pulmonary TB were enrolled. They submitted 492 sputa. There were 73 smear-positive patients (42.9%) and 164 smear-positive sputa (33.3%). While gross appearance was associated with smear positivity in both sexes (purulent or blood-tinged sputum (rather than mucoid sputum or saliva); odds ratio (OR), 2.05, 95% confidence interval (CI), 1.21-3.47 in men; OR, 2.78, 95% CI, 1.23-6.26 in women), the amount of sputum specimens was associated with smear positivity in only female patients (≥4 ml versus <4 ml; OR, 4.96, 95% CI, 1.98-12.37).
Sputum gross appearance and volume were associated with smear positivity. A volume of 4 ml seems to be the the minimum sputum volume acceptable for smear microscopy in females suspected of TB. Those suspected of TB should be encouraged to expectorate grossly qualified sputum specimens.
尽管建议在采集疑似肺结核（TB）病例的痰标本时检查标本质量，但这一程序是基于专家意见。本研究的目的是根据性别阐明痰的外观和量对疑似肺结核患者的涂片阳性率的影响。
2010 年 11 月至 2011 年 6 月，我们连续招募了疑似患有活动性肺结核的患者。调查了痰的外观和量与涂片阳性率的关系，以及可能影响涂片阳性率的其他变量，如症状、疾病范围和胸部 X 光片中的空洞。
在 2439 名接受结核病检查的患者中，有 170 名（113 名男性，57 名女性）患有活动性肺结核，共提交了 492 份痰液。有 73 名涂片阳性患者（42.9%）和 164 份涂片阳性痰液（33.3%）。虽然男性和女性的痰外观都与涂片阳性有关（脓性或血性痰（而非黏液性痰或唾液）；比值比（OR），2.05，95%置信区间（CI），1.21-3.47；OR，2.78，95%CI，1.23-6.26），但仅在女性患者中，痰标本量与涂片阳性有关（≥4 ml 与<4 ml；OR，4.96，95%CI，1.98-12.37）。
痰的外观和量与涂片阳性有关。对于疑似结核病的女性患者，4 毫升似乎是可接受的涂片显微镜检查的最小痰量。应鼓励那些疑似结核病的人咳出大量合格的痰标本。
