Yield of sputum induction in the diagnosis of pleural tuberculosis
Yield of sputum induction in the diagnosis of pleural tuberculosis
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DOI：
10.1164/rccm.2111019
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发表时间：
2003-03-01
影响因子：
24.7
通讯作者：
Kritski, AL
中科院分区：
文献类型：
--
作者：
Conde, MB;Loivos, AC;Kritski, AL
我们前瞻性地评估了在不能自发产生痰液的疑似胸膜结核（TB）患者的检查中使用痰诱导（SI）进行抗酸杆菌涂片和结核分枝杆菌培养的诊断率。在研究的113例患者中，84例患者（71例HIV血清阴性）最终诊断为胸膜结核，29例患者最终诊断为另一种疾病。胸膜活检组织的病理学检查具有最高的诊断率（78%; 66/84）。通过SI获得的胸膜组织的细菌学产率为62%（52/84），胸膜液的细菌学产率为12%（10/84），痰培养的细菌学产率为52%（44/84）。M.在X线检查正常的患者中，肺结核的发生率为55%（35/64）（胸腔积液除外），而在有实质性疾病证据提示肺结核的患者中，肺结核的发生率为45%（9/20）（p = 0.6）。在怀疑有胸膜结核的患者中，即使在胸片上没有肺实质异常的病例中，通过SI获得的痰培养物的产率也很高。
We prospectively evaluated the diagnostic yield of acid-fast bacilli smear and culture for Mycobacterium tuberculosis using sputum induction (SI) in the workup of patients with suspected pleural tuberculosis (TB) who were unable to produce sputum spontaneously. Of the 113 patients studied, a final diagnosis of pleural TB was made in 84 patients (71 HIV seronegative) and a final diagnosis of another disease in 29 patients. Histopathologic examination of the pleural biopsy tissue had the highest diagnostic yield (78%; 66/84). The bacteriologic yield was 62% (52/84) for the pleural tissue, 12% (10/84) for pleural fluid, and 52% (44/84) for sputum cultures obtained by SI. The yield of SI culture for M. tuberculosis was 55% (35/64) in patients with a normal radiograph (except for the pleural effusion) and 45% (9/20) in those with evidence of parenchymal disease suggestive of pulmonary TB (p = 0.6). The yield of sputum cultures obtained by SI is high in patients suspected of having pleural TB even in those cases with no pulmonary parenchymal abnormalities on the chest radiograph.