Comparison of detection values of acid-fast bacilli in sputum by direct smear versus liquid-based cytology smear

Central Plains Medical Journal Pub Date : 2020-03-10 DOI:10.3760/CMA.J.ISSN.1674-4756.2020.05.018

Wenzhe Wu, X. Tian

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Abstract

Objective To compare the detection values of direct smear and liquid-based cytology smear in the detection of acid-fast bacilli in sputum. Methods A total of 4 000 patients with tuberculosis admitted to Binzhou Central Hospital from May 2018 to May 2019 were selected. One sputum sample at night and one sputum sample at morning were collected from every patients. Finally, 8 000 specimens were enrolled in the study in total. Direct smear method and liquid-based cytology smear method were used to detect the 8 000 specimens. And the positive detection rates of acid-fast bacilli in sputum by two methods were recorded. Results The positive detection rates of acid-fast bacilli in the morning sputum sample by liquid-based cytology smear and direct smear were 30.33% (2 426/4 000) and 21.55% (1 724/4 000), respectively, and the positive detection rates of the night sputum samples by the two methods were 22.34% (1 787/4 000) and 12.40% (992/4 000) respectively. Compared with the night sputum samples, the positive detection rates of acid-fast bacilli in the morning sputum samples by two detection methods were higher, and the difference was statistically significant (P<0.05). Compared with direct smear method, the positive rates of acid-fast bacilli in the morning sputum samples and in the night sputum samples detected by liquid-based cytology smear method were higher, and the difference was statistically significant (P<0.05). Among the 8 000 specimens, the positive rates of salivary sputum, mucus sputum, blood sputum and purulent sputum detected by liquid-based cytology smear method were 14.52% (108/744), 12.09% (429/3 548), 65.49% (334/510) and 49.00% (1 567/3 198), respectively, And the positive detection rates of salivary sputum, mucus sputum, blood sputum and purulent sputum detected by direct smear method were 2.96% (22/744), 8.26% (293/3 548), 42.35% (216/510) and 36.34% (1 162/3 198), respectively. Compared with salivary sputum, mucus sputum and purulent sputum, the positive detection rates of acid-fast bacilli in blood sputum by the two methods were higher, and the difference was statistically significant (P<0.05). Compared with the direct smear method, the positive detection rates of sputum, mucus sputum, blood sputum and purulent sputum by liquid based cytology smear method were higher, and the difference was statistically significant (P<0.05). Conclusions The application of liquid-based cytology smear in the detection of acid-fast bacilli in sputum can effectively diagnose pulmonary tuberculosis and provide a basis for clinical diagnosis and treatment. Key words: Tuberculosis; Mycobacterium tuberculosis; Liquid-based cytology smear; Detection technology of acid-fast bacilli

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直接涂片法与液基细胞学涂片法痰中抗酸杆菌检出值的比较

目的比较直接涂片法和液基细胞学涂片法对痰中抗酸杆菌的检测价值。方法选择2018年5月至2019年5月滨州市中心医院收治的结核病患者4000例。每例患者采集1份夜间痰液和1份早晨痰液。最后，总共有8000个标本被纳入研究。采用直接涂片法和液基细胞学涂片法对8 000例标本进行检测。并记录两种方法对痰中抗酸杆菌的检出率。结果液基细胞学涂片和直接涂片对晨痰标本抗酸杆菌检出率分别为30.33%(2 426/4 000)和21.55%(1 724/4 000)，两种方法对夜痰标本抗酸杆菌检出率分别为22.34%(1 787/4 000)和12.40%(992/4 000)。与夜间痰液标本相比，两种检测方法对清晨痰液标本中抗酸杆菌的阳性率均较高，差异有统计学意义(P<0.05)。与直接涂片法相比，液基细胞学涂片法检测早晨痰液标本和夜间痰液标本中抗酸杆菌阳性率较高，差异有统计学意义(P<0.05)。8 000份标本中，液基细胞学涂片法检测唾液、粘液、血、化脓的阳性率分别为14.52%(108/744)、12.09%(429/3 548)、65.49%(334/510)、49.00%(1 567/3 198)，直接涂片法检测唾液、粘液、血、化脓的阳性率分别为2.96%(22/744)、8.26%(293/3 548)、42.35%(216/510)、36.34%(1 162/3 198)。两种方法痰中抗酸杆菌检出率均高于唾液痰、黏液痰和化脓痰，差异有统计学意义(P<0.05)。与直接涂片法相比，液基细胞学涂片法痰、黏液痰、血痰、化脓痰的阳性检出率较高，差异有统计学意义(P<0.05)。结论应用液基细胞学涂片检测痰中抗酸杆菌可有效诊断肺结核，为临床诊治提供依据。关键词:肺结核;结核分枝杆菌;液体细胞学涂片;抗酸杆菌检测技术

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Central Plains Medical Journal

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