萋-尼氏抗酸染色法和金胺O荧光染色法在结核分枝杆菌痰涂片检测中的对比

目的:比较萋-尼氏抗酸染色法（简称Z-N）和金胺O荧光染色法（简称荧光染色）在痰涂片镜检中对结核分枝杆菌的检测效果差异。方法:纳入580份痰标本，挑取相同部位制成两份涂片，分别使用Z-N和荧光染色进行染色镜检，比较两种方法的阳性检出率、阳性分级标准及读片时间上的差异。将涂片后余下的痰标本采用全自动分枝杆菌检测/药敏系统做液体培养。结果:Z-N法阳性检出率为10.8%，荧光染色法为15.3%，两种方法比较差异有统计学意义（P＜0.05）。对两种方法每一级别的结果进行?字2检验，结果表明两种染色方法在各个分级没有统计学差异（P＞0.05）。荧光染色法的读片时间要明显短于Z-N。结论:荧光染色阳性检出率略高于Z-N，证明荧光染色法是一种快速、灵敏的检测方法，对肺结核的临床诊断具有重要意义。

Comparison between Z-N staining method and Auramine O fluorescent staining method in detection of mycobacterium tuberculosis in sputum smear

Objective: To compare the difference of mycobacterium tuberculosis detection effect between Z-N staining method and Auramine O fluorescent staining method in microscopy of sputum smear. Methods: Two smears were prepared for the same site of 580 clinical sputum specimens. Two smears were followed with Z-N and fluorescent staining respectively. The difference between two methods including positive detection rate, the standard of positive classification and time of reading were compared. At the same time, phosphate buffer was used to make 60 copies of smear negative control, staining by Z-N and fluorescence respectively. The remaining sputum specimens were tested by automatic Mycobacterium detection / drug sensitivity system for liquid culture. Results: The positive detection rate using Z-N was 10.8%, that of fluorescent staining was 15.3%, and the difference between two methods were considered statisically significant（P＜0.05）. The results showed that there was no statistical difference between the two staining methods in each grade(P＞0.05). Conclusion: The positive detection rate of fluorescence staining is slightly higher than Z-N. It is proved that fluorescence staining is a fast and sensitive detection method, and it may provide important reference for the clinical diagnosis of tuberculous pleuritis.