加强结核病病理学诊断的临床应用与研究

摘要

结核病是一种由结核分枝杆菌复合群引起的传染性疾病,严重危害着人类的健康.国家卫生和计划生育委员会于2017年11月9日发布了《WS 196-2017结核病分类》与《WS 288-2017肺结核诊断》两项强制性卫生行业标准,并且于2018年5月1日起施行;同时废止《WS 196-2001结核病分类》和《WS 288-2008肺结核诊断》.在《WS 288-2017肺结核诊断》标准中,显著提高了病理学诊断在肺结核诊断和精准治疗中的地位.病理学诊断阳性的患者即可确诊为肺结核;影像学检查结果支持肺结核的诊断,同时分子生物学检查阳性的患者也可以确诊为肺结核.多聚酶链反应(PCR)技术可以快速诊断结核分枝杆菌感染,核酸杂交技术可以快速检测基因的突变位点,判断结核分枝杆菌对抗结核药物的耐药种类和数量.深入学习与贯彻《WS 288-2017肺结核诊断》标准,对于明确和了解病理学诊断在结核病临床诊断和精准治疗方面作用具有十分重要的意义.%Tuberculosis is a kind of infectious disease caused by Mycobacterium tuberculosis complex group,which seriously endangers human health.On November 9,2017,the National Health and Family Planning Commission issued the two mandatory health industry standards for Classification of tuberculosis (WS 196-2017) and Diagnosis for pulmonary tuberculosis (WS 288-2017),and will implement on May 1,2018.At the same time,"Classification of tuberculosis (WS 196-2001)" and "Diagnosis for pulmonary tuberculosis (WS 288-2008)" will be abolished.In the standard of Diagnosis for pulmonary tuberculosis (WS 288-2017),the status of pathological diagnosis in tuberculosis diagnosis and precision treatment is significantly improved.Pulmonary tuberculosis can be diagnosed by pathological diagnosis.The findings of the imaging examination support the diagnosis of tuberculosis,while patients with positive molecular biology can also be diagnosed with tuberculosis.PCR technology can quickly diagnose Mycobacterium tuberculosis infection,the nucleic acid hybridization technique can quickly detect the mutation site of the gene and determine the type of drug resistance of Mycobacterium tuberculosis.Further study and implementation of the standard of Diagnosis for pulmonary tuberculosis (WS 288-2017) is of great importance to clarify and understand the role of pathological diagnosis in the clinical diagnosis and precise treatment of tuberculosis.