| 摘要: |
| ［摘要］ 肺炎是临床上常见的呼吸系统感染性疾病，而细菌是肺炎的最常见病原体。明确引起肺炎的细菌病原体对正确指导抗菌药物治疗具有重要意义。肺炎病原体细菌学检查方法包括细菌培养、细菌抗原检测和聚合酶链反应检测细菌基因。细菌培养标本包括痰液、经无菌导管或纤维支气管镜采集的下呼吸道分泌物、支气管肺泡灌洗液、血液、胸水以及经皮穿刺到达肺炎部位注入生理盐水后回抽获取的液体。痰液、血液以及胸水细菌培养简单方便，临床应用广泛，但阳性率较低；经无菌导管或纤维支气管镜采集下呼吸道分泌物、支气管肺泡灌洗液培养阳性率得到提高但属于有创检查；经皮穿刺注入生理盐水后回抽获取的液体细菌培养阳性率和特异性高。血清或尿细菌抗原检测、痰液或尿液细菌基因检测的细菌种类有限，但敏感性和特异性高，有望在临床上得到更广泛应用。 |
| 关键词: 肺炎 病原体 诊断 |
| DOI：10.3969/j.issn.1674-3806.2011.06.38 |
| 分类号:R 563.1 |
| 基金项目:广西壮族自治区科技厅攻关项目（编号：桂科攻0816004-9）；广西壮族自治区卫生厅卫生适宜技术项目（编号：S200817） |
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| Diagnostic techniques of bacteria in patients with pneumonia |
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LU Ai-ling, QIN Zhi-qiang
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Department of Respiratory Medicine, the People′s Hospital of Guangxi Zhuang Autonomous Region, Nanning 530021, China
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| Abstract: |
| ［Abstract］ Pneumonia is the common infectious disease of respiratory system and bacteria are the major pathogens. Determining the bacteria of pneumonia is significant for antimicrobial therapy. The diagnosis of bacterial pathogens in patients with pneumonia includes culture of bacteria, examination of bacterial antigen and detecting bacterial gene by polymerase chain reaction (PCR). The samples for bacterial culture consist of sputum, tracheal-bronchial aspiration collected through catheter or fiberoptic bronchoscope, bronchial alveolar lavage fluid, blood, pleural effusion and aspiration by transthoracic needle. The bacterial culture of sputum, blood and pleural effusion characterizes both simple techniques and low positive rates. Bacterial culture of aspirations gotten through catheter, bronchoscope or tranthoracic needle is sensitive and specific but invasive. Although the spectrum of detecting bacterial antigens in serum or urine and bacterial genes in sputum or urine is not satisfied, their high sensitivity and specificity would make them more common in clinical practice. |
| Key words: Pneumonia Pathogen Diagnosis |
