痰菌检查结果与咳痰时间的关系

目的探讨痰标本的咳痰时间对抗酸杆菌检查结果的影响,以提高痰菌检出率。方法采用痰直接厚涂片萋一尼氏抗酸染色显微镜（物镜100×）检查2976份痰标本,统计不同咳痰时间的痰标本阳性检出率和不同时间的阳性痰标本的含菌量。结果2976份痰标本中,清晨痰、夜间痰、即时痰阳性检出率差异有统计学意义（X2=6．25,P〈0．05）以清晨痰的阳性率最高。474份阳性痰标本中,清晨痰、夜间痰、即时痰的含菌量差异有统计学意义（X2=20．86,P〈0．01）,以清晨痰的含菌量最高。结论咳痰时间对痰标本抗酸杆菌检出有很大影响;要强调清晨痰的送检,以提高痰菌阳性检出率。     

痰标本的咳痰时间与抗酸杆菌检查结果的分析

目的探讨痰标本的咳痰时间对抗酸杆菌检查结果的影响。方法采用痰直接厚涂片萋-尼氏抗酸染色光学显微镜（物镜100x）检查。结果2125痰标本中，清晨痰、夜间痰、即时痰阳性检出率差异有统计学意义。结论咳痰时间对痰标本抗酸杆菌检出有很大影响。     

不同性状、不同留置时间痰标本涂片抗酸杆菌检出率比较

目的 比较不同性状、不同留置时间的痰标本涂片检查抗酸杆菌的检出水平,探讨痰标本的留置时间、标本质量与抗酸杆菌检出结果的关系. 方法采用痰抗酸杆菌直接涂片检查、萋-尼氏抗酸染色,统计分析不同留置时间和不同性状痰标本的涂片检查的阳性检出率. 结果 3 249份初诊即时、夜间、清晨咳出的干酪痰、血痰、粘液痰、唾液标本的涂片结果差异有统计学意义,清晨痰、干酪痰检出率最高为30.75%、70.03%;不同咳痰时伺、不同性状痰标本中阳性标本的分布,含菌量差异均有统计学意义;目视挑取有效部分涂片与随意挑取涂片阳性检出率差异亦有统计学意义.结论 痰标本的留置时间、标本质量对痰涂片抗酸杆菌检出率有很大影响,清晨痰、干酪痰阳性检出率最高;目视挑取干酪样、脓样或可疑部分进行涂片可显著提高阳性检出率.     

2186例肺结核病人痰标本质量以及咳痰时间与抗酸杆菌检查结果分析

[目的]探讨肺结核病人痰标本抗酸杆菌检查的影响因素. [方法]采用直接厚涂片萋-尼氏法抗酸染色,对临床资料进行回顾分析. [结果]2 186例痰标本,抗酸杆菌阳性516例,阳性率23.6%.痰标本的性状、留痰时间对抗酸杆菌检出有很大影响. [结论]应提高留痰质量,重视晨痰的留取.     

痰液质量对抗酸杆菌检测结果的影响

近年来结核病的发病率呈明显上升趋势,每年全世界新增结核病人800万人,有300万人死于结核病[1].痰液的检查在肺结核的诊断、治疗及流行病学等方面具有十分重要意义.为了解不同性状痰液标本的痰菌检出情况,我们对1432份肺结核患者痰液进行检测和分析,现报告如下.     

35例结核误诊分析

结核是一种常见病、多发病,诊断一般不难,但是由于临床表现多样,缺少特异性表现,常常出现漏误诊.本文收集结核误诊35例,现将误诊原因分析如下.     

35例结核误诊分析

结核是一种常见病、多发病,诊断一般不难,但是由于临床表现多样,缺少特异性表现,常常出现漏误诊。本文收集结核误诊35例,现将误诊原因分析如下。1临床资料1.1对象本组35例患者,其中男20例,女15例,年龄20~70岁。1.2临床情况误诊为支气管肺炎18例;慢性支气管炎2例;支气管扩张2例;     

快速集菌法与直接厚涂片法对抗酸杆菌检出率的比较

现代结核病控制的基本策略之一就是优先发现和治愈传染源。结核病人的细菌学检查 ,是发现传染源的最主要途径和手段 ,是确定结核诊断和化疗方案的重要依据 ,也是考核疗效、评价防治效果的可靠标准[1] 。涂片染色镜检是目前应用最广泛的细菌学检查方法。镜检法有直接厚涂片法和集菌法两种不同检查方法 ,而集菌法又分普通集菌法和快速集菌法。为比较快速集菌法与直接厚涂法两者涂阳检出率 ,对 35 0名肺结核可疑者的晨痰分别用快速集菌法和直接厚涂片法检查 ,现将结果报告如下。1　材料与方法1 1　标本来源　基层医疗单位转诊的可疑肺结核患者…     

Demonstration of acid-fast bacilli in skin biopsies from indeterminate leprosy cases

Because the correct diagnosis of indeterminate leprosy (IL) requires the finding of acid-fast bacilli in skin lesions from clinically and histopathologically suggestive cases, it is necessary to develop a reliable method for this purpose. This paper presents a simple procedure, available to every general laboratory, which consists in obtaining 2 suspensions: SI, by mincing and grinding the tissue in phosphate-buffered saline; and SII, after treating SI with NaOH solution and digesting with trypsin. In 22 IL skin biopsies, bacilli were directly observed in only 3 with the Ziehl-Neelsen (ZN) stain; and with the peroxidase-antiperoxidase method it was impossible to differentiate between nonspecific precipitate and true positive reactions. In contrast, 18 positive results from the same 22 samples were obtained when both SI and SII were evaluated with ZN stain. The logarithmic bacterial index was also increased in at least 7 cases.     

探讨次氯酸钠在血样痰标本检测抗酸杆菌中的临床应用

目的 探讨用5％次氯酸钠对血样痰标本进行液化溶血处理在抗酸杆菌检测中的临床应用.方法 对同一病人的血样痰标本一组直接涂片做抗酸染色（对照组B）,另一组将标本加入5％次氯酸钠进行液化溶血处理,取沉渣进行抗酸染色（实验组A）,采用配对资料的x 2检验对两组数据进行统计学处理.结果 对86份高度怀疑为肺结核病人的血性痰标本用上上述不同的方法检测抗酸杆菌,直接涂片法抗酸杆菌的检出率为41.86％ （36/86）;用5％的次氯酸钠进行液化溶血后取沉渣进行抗酸染色其抗酸杆菌检出率为75.58％（65/86）,两组比较（P＜0.05）差异有统计学意义.结论 血样痰标本用5％次氯酸钠液化溶血后取沉淀进行抗酸染色,能大幅度提高血样痰标本中抗酸杆菌的检出率.     

集菌涂片染色法在检测痰液中抗酸杆菌的临床应用

目的探讨离心沉淀集菌法对痰涂片抗酸染色法检查结核分枝杆菌阳性率的影响。方法计算2015-2018年江苏省使用离心沉淀集菌法的南京、无锡和苏州3市与本省其他未使用该方法地区的涂阳病人发现率,采用描述性流行病学方法比较不同年份、城市和不同方法涂阳病人发现率。结果采用离心沉淀集菌法的南京、无锡和苏州市,2015-2018年平均涂阳病人占总病人数分别为39.11%、38.34%和40.01%,高于其他未使用地区(平均32.20%),差异均有统计学意义(P值均0.05);与未使用该方法地区相比,使用该方法地区平均涂阳病人发现率显著升高(P值均0.05)。结论离心沉淀集菌法可有效增强痰标本抗酸杆菌染色镜检的灵敏度。该方法相对简便、易于操作,提高了含菌量低标本的检出率,适合在基层实验室推广。     

A technically simple method for staining of acid-fast bacilli in cytology smears: an evaluation

OBJECTIVE: To study the effects of modifications in the Ziehl-Neelsen staining procedure on predictive accuracy for acid fast bacilli in comparison to the conventional technique. Simplicity of procedure and reagent economy were the factors taken into consideration. DESIGN: Comparative evaluation between thick and thin air-dried smears stained conventionally and thick ethanol-fixed smears stained by the modified technique was done. RESULTS: Positive predictive accuracy of all the three smears, that is, thick air-dried, thin air-dried and thick ethanol-fixed, was 100%. Negative predictive accuracy for thick air-dried, thin air-dried and thick ethanol-fixed smears was 36.36%, 32.33% and 34.78%, respectively. Overall predictive accuracy was 66.67% for thick air-dried, 61.90% for thin air-dried and 64.29% for thick ethanol-fixed. These differences were found to be statistically insignificant. CONCLUSION: The modified method offers an accuracy comparable to the conventional technique, is simpler and with improved reagent economy. It is of special importance to diagnostic facilities in rural set-ups.     

A quick method of demonstrating bacillaemia in patients with lepromatous leprosy and ultrastructural studies of the circulating acid-fast bacilli

While studying circulating immune complexes (CIC) in the sera of lepromatous patients by the polyethylene glycol (PEG) precipitation technique, we found (by light microscopy) abundant acid-fast bacilli (AFB), morphologically similar to those seen in slit skin smear preparations from these patients, precipitated with the PEG precipitated materials. Both solid and non-solid AFB could be readily identified. Ultrastructures of these AFB in the PEG aggregates showed some similarity with those detected in the PEG precipitates prepared from armadillo-derived lepromin under identical conditions. The most striking difference between the AFB in the test sera and that in the armadillo-derived lepromin was the absence of any transverse band in the former. This suggested that the AFB in the patients' circulation were not in division stage. Furthermore, electron-dense material were deposited on the AFB co-precipitated from the patients' sera, which were not found on the AFB co-precipitated from the armadillo-derived lepromin.     

全自动显微扫描系统与人工镜检检测痰标本中抗酸杆菌的效果比较

【目的】比较全自动显微扫描系统与人工镜检检测痰标本中抗酸杆菌的效果。【方法】选择上海市5家结核病定点医院作为研究现场,连续纳入2020年1—11月肺科门诊初诊的疑似肺结核患者1 519例,对收集到的每例疑似肺结核患者痰标本分别进行痰涂片和BACTEC MGIT 960液体培养(简称“液体培养”)检查。痰涂片检查采用直接涂片法制作2张痰涂片,1张采用传统萋-尼氏抗酸染色人工镜检,另1张采用自动染片机萋-尼氏抗酸染色全自动显微扫描系统进行扫描。以液体培养结果为标准,比较人工镜检和全自动显微扫描系统检测痰标本中抗酸杆菌的效能。分析全自动显微扫描系统重复性扫描结果和人工镜检复核结果。【结果】全自动显微扫描系统阳性检出率为14.4%(219/1 519),人工镜检阳性检出率为16.3%(248/1 519),两者差异无统计学意义(χ²=2.13,P=0.145)。以液体培养结果为标准,人工镜检检测痰标本中抗酸杆菌的灵敏度60.36%(236/391)高于全自动显微扫描系统52.94%(207/391),差异有统计学意义(χ²=4.38,P=0.036)...     

The influence of averaging time on the distribution of exposures

Personal exposures to toxic airborne agents in the work environment often are approximately log-normally distributed. While the arithmetic mean of these distributions is independent of the averaging time of the measurement in a stationary environment, this is not the case for the variance. In general, the variance decreases with increasing averaging time, but the rate of decrease depends upon the autocorrelation structure of the exposure time series. If the autocorrelation structure can be determined, a knowledge of the parameters of the distribution of exposures at one averaging time allows the estimation of those for any other averaging time. Regardless of the autocorrelation situation, these results suggest that current ACGIH guidelines for assessing short-term exposures need examination and may require modification.