临床儿科杂志 ›› 2014, Vol. 32 ›› Issue (8): 709-.doi: 10.3969 j.issn.1000-3606.2014.08.003

• 呼吸系统疾病专栏 • 上一篇    下一篇

纤维支气管镜在支气管内膜结核病诊断中的价值

孟燕妮,陈艳萍,李秀龙,黄建宝   

  1. 湖南省儿童医院呼吸二科 ( 湖南长沙 410007)
  • 收稿日期:2014-08-15 出版日期:2014-08-15 发布日期:2014-08-15
  • 通讯作者: 陈艳萍 E-mail:huchengyanping@163.com

Diagnostic value of fiberobronchoscopy in endobronchial tuberculosis

MENG Yanni, CHEN Yanping, LI Xiulong, HUANG Jianbao   

  1. Department of Respiratory, Hunan Children's Hospital, Changsha 410007, Hunan, China
  • Received:2014-08-15 Online:2014-08-15 Published:2014-08-15

摘要: 目的 评价纤维支气管镜对支气管内膜结核病的诊断价值。方法 2010年3月至2012年12月疑诊支气管内膜结核住院患儿67例,均行胸部CT及纤维支气管镜检,支气管肺泡灌洗液(BALF)作结核杆菌培养、荧光定量PCR、夹层杯法和病理活检。结果 经检查临床确诊支气管内膜结核50例,支气管内膜结核镜下病变部位广泛、形态多样化。支气管内膜结核患儿的BALF FQ-PCR检测阳性率为60%,夹层杯法阳性率42%,灌洗液结核菌培养阳性率20%;病理活检阳性率46%;BALF FQ-PCR联合夹层杯法检测,阳性率可提高至76%(38/50),明显高于灌洗液结核菌培养和病理活检阳性率。结论 纤维支气管镜检查为诊断支气管内膜结核的有效手段。

Abstract: Objective To assess the value of fiberobronchoscopy in the diagnosis of endobronchial tuberculosis. Methods A total of 67 children suspected of endobronchial tuberculosis in our ward from March 2010 to December 2012 had been tested by chest CT and fiberobronchoscopy, mycobacteria culture, liquid-based interlayer vessel technique and FQ-PCR from bronchoalveolar lavage fluid and biopsy. Results 50 patients were clinically diagnosed as endobronchial tuberculosis. The positive rate of FQ-PCR (60%) and liquid-based interlayer vessel technique (42%) are higher than that of mycobacteria culture (20%), which showed no significant difference with biopsy. The positive rate of the combined detection (FQ-PCR and liquid-based interlayer vessel technique) is significantly higher than that of mycobacteria culture and biopsy. Conclusions Fiberobronchoscopy is effective for the diagnosis of endobronchial tuberculosis.