目的：评估利用液基夹层杯离心涂片集菌技术检测支气管肺泡灌洗液中抗酸杆菌对菌阴肺结核的临床诊断价值。方法选取我院收治的106例菌阴肺结核患者，所有患者均进行支气管肺泡灌洗液液基夹层杯离心涂片集菌法，荧光定量PCR(FQ-PCR）法，罗氏培养进行抗酸杆菌检测。并通过与罗氏培养法的比较分析液基夹层杯离心涂片集菌法的灵敏度、特异度及临床应用价值。结果罗氏培养法和液基夹层杯离心涂片集菌法对临床确诊的菌阴肺结核患者支气管肺泡灌洗液抗酸杆菌检出率分别为66.0%，70.7%，两者的阳性率比较，差异无统计学意义(χ2=1.231，P=0.267，P＞0.05)。结论液基夹层杯离心涂片集菌法检测支气管肺泡灌洗液抗酸杆菌，具有快速、敏感度和特异度较高的优点，对肺结核具有较高的诊断价值，为痰涂片阴性及无痰患者提供良好的诊断依据。%Objective To assess the diagnostic value of sputum bacterium negative pulmonary tuberculosis with detection of acid-fast bacillus in brocho-alveolar lavage fluid (BALF) by liquid-based interlayer vessel technique. Methods Selecting 106 cases of hospitalized patients with sputum bacterium negative tuberculosis,the methods of liquid-based interlayer vessel tech-nique,fluorescence quantitative PCR (FQ-PCR) and L-J culture were used to detect mycobacterium tuberculosis in BALF derived from all patients. the sensitivity,specificity and clinical application value of liquid-based interlayer vessel technique were evaluat-ed by comparing with the L-J culture method. Results The detection rate of acid-fast bacillus with L-J culture method and liq-uid-based interlayer vessel technique was 66.0%,70.7%respectively in BALF derived from patients with sputum bacterium nega-tive pulmonary tuberculosis,there was no significant difference in the positive rate detected by the two methods(chi-square=1.231, P=1.231,P>0.05). Conclusion liquid-based interlayer vessel technique has the advantages of faster,more sensitive and specific, and it has high value in the diagnosis of pulmonary tuberculosis and provide a good basis for the diagnosis of patients with sputum smear negative and patients without sputum.
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