Abstract:

Objective　To investigate the clinical value of sandwich cup centrifuge smear method for detecting acid-fast bacteria. Methods　The test results of sputum and bronchial lavage fluid by smear staining and mycobacterium isolation were collated from the LIS system of the Department of Clinical Laboratory of Guangzhou Chest Hospital from January to July 2021. The results of direct smear method and sandwich cup centrifuge smear method for acid-fast bacteria of multiple sputum and bronchial lavage fluid samples which were collected within one week interval from the same patient were analyzed retrospectively. Results　Of the 241 sputum samples, 178 bronchial lavage fluid samples, and all 419 samples tested, the positive rates of direct smear method and sandwich cup centrifuge smear method were 15.35% (37/241) and 13.69% (33/241), 15.17% (27/178) and 12.92% (23/178), 15.27% (64/419) and 13.37% (56/419), respectively. Of the 65 positive sputum samples, 50 positive bronchial lavage fluid samples, and all 115 positive samples detected by mycobacterium isolation during the same period, the positive rates of direct smear method and sandwich cup centrifuge smear method were 56.52% (65/115) and 50.78% (65/128), 54.34% (50/92) and 45.88% (50/109), 55.56% (115/207) and 48.73% (115/236), respectively. In the 241 sputum samples, the proportions of samples with direct smear (+) and sandwich cup centrifuge smear (+), direct smear (+) and sandwich cup centrifuge smear (-), direct smear (-) and sandwich cup centrifuge smear (+), and direct smear (-) and sandwich cup centrifuge smear (-) were 12.03% (29/241), 3.32% (8/241), 1.66% (4/241), and 82.99% (200/241), respectively, and those in the 178 bronchial lavage fluid samples were 8.99% (16/178), 6.18% (11/178), 3.93% (7/178), and 80.90% (144/178), respectively. Conclusion　The overall positive rate of sandwich cup centrifuge smear method is slightly lower than that of direct smear method, but it has positive clinical application value because it can find a considerable proportion of etiologically positive tuberculosis patients that can not be found by direct smear method, especially in bronchial lavage fluid samples.

Key words:

Acid-fast bacteria,  , Acid-fast staining,  , Sandwich cup centrifuge smear method, Direct smear method

摘要：

目的　探讨液基夹层杯涂片法查找抗酸杆菌检验方法的临床应用价值。方法　从广州市胸科医院医学检验科LIS系统中收集、整理2021年1月至7月痰液与支气管冲洗液主要送检临床样本的涂片染色检查和分枝杆菌培养结果，对同一患者时间间隔不超过1周的直接涂片与液基夹层杯涂片查找抗酸杆菌检验的结果进行回顾性分析。结果　在241份痰液样本、178份支气管冲洗液样本和全部419份样本的检测中，直接涂片法、液基夹层杯涂片法的阳性率分别为15.35%（37/241）和13.69%（33/241）、15.17%（27/178）和12.92%（23/178）、15.27%（64/419）和13.37%（56/419）。在同期分枝杆菌培养结果阳性的65份痰液样本、50份支气管冲洗液样本和115份全部阳性样本中，直接涂片法、液基夹层杯涂片法的阳性率分别为56.52%（65/115）和50.78%（65/128）、54.34%（50/92）和45.88%（50/109）、55.56%（115/207）和48.73%（115/236）。在241份痰液样本、178份支气管冲洗液样本检测中，直接涂片阳性且液基夹层杯涂片阳性、直接涂片阳性且液基夹层杯涂片阴性、直接涂片阴性且液基夹层杯涂片阳性、直接涂片阴性且液基夹层杯涂片阴性的样本占比分别为12.03%（29/241）、3.32%（8/241）、1.66%（4/241）、82.99%（200/241）和8.99%（16/178）、6.18%（11/178）、3.93%（7/178）、80.90%（144/178）。结论　液基夹层杯涂片法查找抗酸杆菌检验方法总体阳性检出率略低于直接涂片检测法，但可以发现相当比例的直接涂片法阴性的病原学阳性结核病患者，尤其是在支气管冲洗液检测中，具有一定的临床应用价值。

关键词:

抗酸杆菌, 抗酸染色, 液基夹层杯涂片法, 直接涂片法