Diagnostic method _'s symptom of tubercle

Diagnostic method _'s symptom of tubercle
The diagnosis of tubercle is except depending on medical history, X-ray, organize examining alive in main foundation or the Kveim's skin is tested.
1.Organize examining alive: ( 1) Draw materials from the simple table position at first, such as lymph node, rash, skin lower tubercle,etc., if the fat cushion lymph node of skin of oblique angle before being negative and desirable. ( 2) Fetch the mucous membrane of bronchus to live and examine under the fibrous bronchus mirror and fetch the lung and organize examining (TBLB) alive through the bronchus wall ,Many can obtain the positive result, especially chest X-ray 2 stage, a patient, the positive rate can be up to 63% one 97%.
2.Kveim experiment: Fetch active the intersection of tubercle and the intersection of disease and lymph node of patient or spleen do the antigen make brine to drift along, hang liquids, with the intersection of 0.1-0.2ml and the intersection of forearm and intradermal injection, excise this department skin after the 4- 8 week, competent pathology live, examine, the intersection of skin and kinds of the intersection of cell and tubercle get positive at the cheese such as show. The positive rate is about 65% one 92%. This experimental principle majority think that relate to cell immunity, may be in order to send a kind of type of hypersensitivity late.
3.Form and usually react: Tubercle cell immunity low at the disease, show as, form, react usually (5 old plain knot of unit) Negative or weak and positive. This law is one of the auxiliary diagnostic methods.
4.Invertase of angiotensin (Angiotension Converting Enzyme, ACE) : The blood vessel is changed tensely and plainly into angiotensin 2 with function of stepping up through ACE in lung capillary endothelial cells. Libermann finds the tubercle activity one, ACE increases in blood, there is certain help on the diagnosis of tubercle, especially judgement of the active state of pathological change.
5.The bronchus alveolus irritates lotion (BAL) Cytologic inspection: It is more sensitive than ACE that someone thinks BAL cytologic and checks to the diagnosis of tubercle and early alveolus inflammation and estimation of activity. It is shown as: The total number of cells increases; Lymphocytes increase (normal people account for 7% of the total number of cells, the tubercle patient can be up to 50%) ; T lymphocytes increase, can account for more than 28% of the total number of cells; It is auxiliary T lymphocyte /if you can't inhibit by T lymphocyte rate from, increase, be can rise to by l0.5/1 from 1.8/1.
6.67 gallium ( 67Ga) Scan: 67Ga assemble in the inflammation granulation swollen supersession activeness and hyperplasia strong area more, this may relate to the dissolving fungus enzyme and combining together and developing of neutral cells. The tubercle patient 67Ga index increases and becomes positive correlation with the total number of BAL lymphocytes, T lymphocyte number, quite helpful to the diagnosis of the inflammation intensity of alveolus, it is also the index of the activity of tubercle at the same time.
7.The active determination of peptide enzyme in the metal: The activity of tubercle patient this enzyme is higher than the control group by 3 times. The tubercle activity one is higher than non-activity by 2 times of one. And 4 times higher than the normal control group. Activity and control group of active tuberculosis, bronchus lung cancer, fiber case of the quality specially among the sending lung, this enzyme, do not have obvious difference. Explain the determination of this enzyme, there is certain help on diagnosis and activity one of tubercle.
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