Kuaban C, Herer B, Papillon F, Offredo-Hemmer C, Huchon G, Chrétien J
Université René-Descartes, Hôpital Laënnec, Paris.
Ann Med Interne (Paris). 1989;140(4):269-73.
To determine the influence of socio-economic, clinical and radiological factors on the detection of a Mycobacterium tuberculosis-positive direct sputum smear, we studied 531 patients hospitalized for pleuropulmonary tuberculosis over a 5 year period. M. tuberculosis positivity of the expectorate smear was found more frequently in clinically detected (43%) than in radiologically detected (26%) tuberculosis (P less than 0.001). On admission, a M. tuberculosis-positive sputum smear was more common in patients under 40 years old (P less than 0.02), blacks (P less than 0.05) and alcoholics (P = 0.001). M. tuberculosis positivity on direct sputum smears was more often associated with general (asthenia, sweating, fever greater than 38 degrees C) and functional respiratory symptoms (cough and sputum production) (P less than 0.003), bilateral diffusion of lung lesions and/or excavation on chest roentgenography (P less than 0.0001). Nevertheless, 21% of the asymptomatic radiologically detected tuberculosis patients had positive direct expectorate smears and should be considered contagious.
为确定社会经济、临床及放射学因素对结核分枝杆菌阳性直接痰涂片检测的影响，我们研究了531例在5年期间因胸膜肺结核住院的患者。临床诊断的结核病患者痰涂片结核分枝杆菌阳性率（43%）高于放射学诊断的患者（26%）（P<0.001）。入院时，结核分枝杆菌阳性痰涂片在40岁以下患者（P<0.02）、黑人（P<0.05）及酗酒者（P=0.001）中更为常见。直接痰涂片结核分枝杆菌阳性更常与全身症状（乏力、盗汗、体温>38℃）及功能性呼吸症状（咳嗽、咳痰）相关（P<0.003），与胸部X线片显示的肺部病变双侧播散和/或空洞形成相关（P<0.0001）。然而，21%无症状的放射学诊断的结核病患者直接痰涂片阳性，应被视为具有传染性。
