中国麻风皮肤病杂志 ›› 2025, Vol. 41 ›› Issue (5): 326-329.doi: 10.12144/zgmfskin202505326

• 论著 • 上一篇    下一篇

脱蜡液及脱色液对麻风分枝杆菌抗酸染色检出率的影响

王丰,程伟,曾学思,陈浩,邵雪宝,宋昊   

  1. 中国医学科学院 北京协和医学院皮肤病医院病理科，江苏南京，210042
  • 出版日期:2025-05-15 发布日期:2025-05-14

Influence of dewaxing solution and decolorizing solution on acid-fast staining detection rate of Mycobacterium leprae

WANG Feng, CHENG Wei, ZENG Xuesi, CHEN Hao, SHAO Xuebao, SONG Hao   

  1. Department of Pathology, Hospital for Skin Diseases (Institute of Dermatology), Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing 210042, China
  • Online:2025-05-15 Published:2025-05-14

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摘要： 目的：比较环保脱蜡液以及两种脱色液对麻风石蜡切片麻风分枝杆菌检出率的影响。方法：对既往病理诊断为麻风的41例皮肤组织标本分别使用3种方法进行处理：二甲苯作为透明脱蜡液、环保脱蜡液作为透明脱蜡液以及在环保脱蜡液作为透明脱蜡液的基础上，使用20%硫酸水溶液和1%盐酸酒精溶液作为脱色液。采用Zienkl-Neelsen抗酸染色法检测各组麻风分枝杆菌密度和形态。结果：环保脱蜡液组的分枝杆菌阳性率为63.4%高于二甲苯组的58.5%。1%盐酸酒精组的分枝杆菌阳性率与20%硫酸水溶液组相同，为63.4%。在环保脱蜡液的基础上使用20%硫酸水溶液脱色差异率为31.7%，使用1%盐酸酒精脱色的差异率为63.4%，差异有统计学意义(P＜0.05）。抗酸染色后麻风分枝杆菌呈鲜红色，1%盐酸酒精脱色镜下背景呈紫红色，20%硫酸水溶液脱色背景呈灰蓝色，颜色背景与麻风杆菌颜色对比更明显，2名医生独立阅片结果示2种方法中抗酸杆菌形态指数差异例数分别为26例和13例，差异有统计学意义（χ2=8.264，P＜0.05）。 结论：与二甲苯相比，使用环保脱蜡液有利于提高麻风分枝杆菌抗酸染色检出率；20%硫酸水溶液脱色的切片背景清晰，颜色更加分明，有利于判读麻风分枝杆菌的形态。

关键词: 麻风分枝杆菌, 抗酸染色, 环保脱蜡液, 脱色液

Abstract: Objective: To compare the effects of eco-friendly dewaxing solution and two different decolorizing solutions on acid-fast staining of granuloma paraffin sections. Methods: Three methods were applied to process 41 skin tissue specimens previously pathologically diagnosed with leprosy: xylene as a clearing and dewaxing solution, an eco- friendly dewaxing solution as a clearing and dewaxing solution, and 20% sulfuric acid aqueous solution or 1% hydrochloric acid alcohol solution as a decolorizing solution after specimens dewaxed by eco-friendly dewaxing solution. The Zienkl - Neelsen acid - fast staining method was used to detect the density and morphology of Mycobacterium leprae in each group. Results: The positivity rate of Mycobacterium leprae in the eco-friendly dewaxing solution group was 63.4%, higher than 58.5% in the xylene group. The positivity rate of Mycobacterium leprae in the 1% hydrochloric acid alcohol group was the same as that in the 20% sulfuric acid aqueous solution group, which was 63.4%, with a significant difference (P＜0.05). After acid - fast staining, Mycobacterium leprae showed bright red under the microscope. The background after decolorization with 1% hydrochloric acid-alcohol was purplish red, and the background after decolorization with 20% sulfuric acid aqueous solution was gray - blue, in which color contrast between the background and Mycobacterium leprae was more obvious. After all specimens were decided by two doctors independently, the result showed that the difference specimens of acid - fast bacilli morphological indexes between the two methods were 26 and 13 respectively, with a significant difference (χ2 =8.264, P＜0.05). Conclusion: Compared with xylene, eco-dewaxing solution is beneficial for improving the detection rate of Mycobacterium leprae acid-fast staining. The color contrast between the background and Mycobacterium leprae was more obvious using 20% sulfuric acid aqueous solution as a decolorizing solution, which is help to identify of Mycobacterium leprae.

Key words: Mycobacterium leprae, acid-fast staining, environmental dewaxing solution, decolorizing fluid