摘要
目的探讨老年急性血行播散性肺结核临床特点。方法回顾性分析首都医科大学附属北京胸科医院2007年1月至2013年3月间收治的33例老年急性血行播散性肺结核患者的临床资料。结果33例患者以发热及咳嗽、咯痰、倦怠乏力、纳差为主要临床表现;涂阳患者7例,痰结核分枝杆菌罗氏培养阳性患者4例;影像学检查表现为双肺大小、密度、分布"三均匀"的粟粒结节影32例;营养风险评估≥3分32例,30例合并低蛋白血症,29例患者全血总淋巴细胞计数≤1.2×109/L;32例患者合并高危或慢性基础疾病,并发结核性脑膜炎8例,骨关节结核6例;有16例患者出现误诊;30例患者接受个体化抗结核治疗,25例患者病情好转。结论老年急性血行播散性肺结核患者多病情危重,合并症多,临床表现不典型,误诊率高,营养不良多见,但经积极个体化治疗后,大多数患者病情可以好转。
Objective To evaluate clinical characteristics of elder patients with acute hematogenous disseminated pulmonary tuberculosis. Methods We analyzed retrospectively the clinical data from 33 elder patients with acute hemotogenous pulmonary tuberculosis hospitalized in Beijing Chest Hospital Affiliated Capital Medical University in recent 6 years. Results In 33 patients, the mainly clinical symptoms presented were fever, cough, fatigue and anorexia. Seven cases with positive smear,while 4 cases with positive sputum culture. The chest X-ray or computed tomography （CT） showed miliary nodules in whole lung field of double lungs in 32 cases. Nutritional risk assessment score were more than 3 scores in 32 cases, 30 cases were complicated with hypoalbuminemia, 29 cases with total lymphocyte counts below 1.2×109/L. Thirty-two patients with high-risk or chronic diseases, 8 patients with tuberculous meningitis, 6 cases with bone joint tuberculose and 16 cases were misdiagnosed with other diseases. Thirty cases were treated with individual anti-tuberculosis therapy regimens and 25 patients were improved. Conclusion Acute hematogenous disseminated pulmonary tuberculosis in elder patients is serious, with many complications, untypical clinical manifestations, high rate of misdiagnosis and malnutrition. However most patients can get better when they are treated individually.
出处
《中国防痨杂志》
CAS
2013年第11期927-929,共3页
Chinese Journal of Antituberculosis
关键词
结核
肺
传播
老年人
Tuberculosis pulmonary/transmission
Aged
