Kawada H, Suzuki N, Takeda Y, Toyoda E, Takahara M, Kobayashi N, Suzuki T, Kudo K, Kabe J
Division of Respiratory Disease, International Medical Center of Japan, Tokyo, Japan.
Kekkaku. 1996 Nov;71(11):603-6.
This study was designed to compare the results of culture for tubercle bacilli using induced sputum by an ultrasonic nebulizer and gastric aspirates from same patients who were suspected of having active tuberculosis with little or no sputum and had received no prior chemotherapy. 22 patients included in this series were either culture positive for tubercle bacilli or showed unequivocal radiographic improvement after three months of therapy with three anti-tuberculosis drugs. Induced sputum from 17 patients and gastric aspirates from seven patients were culture positive for M.tuberculosis. This difference is significant (p < 0.01). Paired induced sputum and gastric aspirates were both positive for tubercle bacilli in seven patients. The finding of acid-fast bacilli on microscopy or tubercle bacilli in culture in four of the seven patients were available much earlier with induced sputum than with gastric aspirates. Positive gastric aspirates and negative induced sputum for tubercle bacilli was not seen. These results suggest that induced sputum by an ultrasonic nebulizer is superior to gastric aspirates in terms of high sensitivity and early finding for tubercle bacilli and induced sputum and gastric aspirates do not supplement each other.
本研究旨在比较超声雾化诱导痰与同一组疑似活动性肺结核且痰少或无痰且未接受过化疗患者的胃抽吸物中结核杆菌培养的结果。本系列纳入的22例患者，要么结核杆菌培养呈阳性，要么在接受三种抗结核药物治疗三个月后影像学有明确改善。17例患者的诱导痰和7例患者的胃抽吸物结核分枝杆菌培养呈阳性。这种差异具有统计学意义（p<0.01）。7例患者的配对诱导痰和胃抽吸物结核杆菌均呈阳性。在这7例患者中，4例患者通过诱导痰比通过胃抽吸物更早发现显微镜下抗酸杆菌或培养中的结核杆菌。未发现胃抽吸物结核杆菌阳性而诱导痰阴性的情况。这些结果表明，超声雾化诱导痰在结核杆菌的高敏感性和早期发现方面优于胃抽吸物，且诱导痰和胃抽吸物不能相互补充。
