Objective To explore the clinical and electronic bronchoscopic features ofendobronchial tuberculosis with negative sputum acid-fast bacillus. Methods Clinical symptoms, chest X-ray/CT manifestations and bronchoscopic findings of 69 cases with endobronchinal tuberculosis were investigated retrospectively. Results Roentgenographic appearance were exudation, atelectasis and bronchitis, 12 patients (17.2％) had clear lung fields. Under electronic bronchoscopy, exudative lesions in 28 cases, ulceration lesions in 18 cases, granulomatous lesions in 15 cases, and occlusive lesions in 8 cases. The successful detection rate of biopsy and brushing smear were 87.0％ and 84.1％ respectively. Conclusion The clinical manifestations and roentgenographic appearances of endebronchial tuberculosis with negative sputum acid-fast bacillus are not specific, so electronic bronchoscopy is mandatory for the prompt diagnosis, and bronchial biopsy and brushing smear examination for acid-fast bacillus are beneficial to rapid and definite diagnosis.%目的 探讨痰菌阴性支气管内膜结核的临床及电子支气管镜下特点.方法 回顾性分析本院经电子支气管镜检查后确诊痰菌阴性支气管内膜结核69例的临床、胸部影像和电子支气管镜下表现.结果 X线胸片或胸部CT片显示肺部渗出性改变、肺不张及支气管炎,23.2%的患者肺部未见异常.电子支气管镜下所见分为浸润型、溃疡型、肉芽增殖型、闭塞型.钳检病理学阳性率87.0%,刷检物涂片抗酸杆菌阳性率84.1%.结论 痰菌阴性支气管内膜结核的临床症状与X线表现无特征性,电子支气管镜检查中联合活检组织病理及刷检物涂片抗酸杆菌检测是有效的诊断手段.
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