摘要
目的:分析新型冠状病毒(简称“新冠病毒”)感染合并肺结核患者的临床表现、影像学特征及实验室检查指标情况,探讨合并肺结核对新冠病毒感染患者预后的影响。方法:选取2022年12月至2023年1月于湖南省胸科医院住院并明确诊断为新冠病毒感染的患者作为研究对象,共140例。研究对象中单纯新冠病毒感染患者57例(新冠组);新冠病毒感染合并肺结核患者83例(新冠合并结核组),其中,合并耐药肺结核患者32例。收集研究对象的人口学特征、临床特征、实验室检查结果、预后情况。采用病例-对照设计,首先根据研究对象是否合并肺结核,将其分为新冠组和新冠合并结核组,比较两组研究对象的人口学特征、临床表现、实验室检查结果及预后情况;然后,将新冠合并结核组按照是否耐药、是否痰菌阳性、治疗分类进行分层分析。采用Kaplan-Meierr(KM)生存分析比较组间的生存差异,并进一步探讨影响合并肺结核对新冠病毒感染患者预后的危险因素。结果:新冠合并结核组的预后更差,CT影像学恢复时间[中位数(四分位数)]为8.5(7.0,11.5)d,与新冠组相比[7.0(5.0,10.0)d],差异有统计学意义(U=785.000,P=0.049)。新冠合并结核组患者首发症状不典型,发热的患者占38.6%(32/83),低于新冠组(56.1%,32/57),差异有统计学意义(χ^(2)=4.311,P=0.040)。两组患者的影像学表现也有较大差异,新冠组最常出现的是典型磨玻璃影(52.6%,30/57),高于新冠合并结核组的21.7%(18/83),差异有统计学意义(χ^(2)=14.362,P<0.001);新冠合并结核组的影像学表现复杂,最常见的为斑片影(91.6%,76/83)和条索影(91.6%,76/83),高于新冠组的56.1%(32/57)和28.1%(16/57),差异均有统计学意义(χ^(2)值分别为24.052和60.471,P值均<0.001)。新冠合并结核组患者的淋巴细胞计数[中位数(四分位数)]为1.0(0.7,1.6)×10^(9)/L,明显低于新冠组的1.3(0.9,2.0)×10^(9)/L,差异有统计学意�
Objective:This study aims to delineate the clinical presentations,radiographic features,and laboratory findings of patients co-infected with the novel coronavirus(COVID-19)and pulmonary tuberculosis,with a particular focus on assessing the prognostic implications of tuberculosis in the context of COVID-19 infection.Methods:The cohort comprised 140 patients admitted to Hunan Provincial Chest Hospital between December 2022 and January 2023 with confirmed COVID-19 infection.This group included 57 patients with isolated COVID-19 infection and 83 patients with concurrent pulmonary tuberculosis,of which 32 were diagnosed with drug-resistant tuberculosis.Comprehensive data on demographic characteristics,clinical manifestations,laboratory diagnostics,and outcomes were systematically gathered for analysis.A case-control study design was utilized.Initially,subjects were stratified into either the isolated COVID-19 group or the COVID-19 with tuberculosis co-infection group,facilitating a comparative analysis of demographic data,clinical manifestations,laboratory outcomes,and prognostic data.Subsequently,patients within the tuberculosis co-infection group were further categorized based on drug-resistance status,sputum test results,and treatment classification to refine the analytical depth.Kaplan-Meier survival analysis was employed to delineate the survival disparities between the groups.This analysis was instrumental in further identifying and evaluating the risk factors that may influence the prognosis of patients afflicted with both COVID-19 and pulmonary tuberculosis.Results:Patients co-infected with COVID-19 and tuberculosis exhibited a notably poorer prognosis,as evidenced by prolonged chest imaging recovery times(median(interquartile range,IQR))of 8.5(7.0,11.5)days,compared to 7.0(5.0,10.0)days in the COVID-19-only group,achieving statistical significance(U=785.000,P=0.049).Furthermore,initial symptoms in the co-infected cohort were less typical,with fever presenting in only 38.6%(32/83)of cases,significantly lower t
作者
李瑶
方喆
罗丹霖
胡艳梅
唐蜜
唐志冈
文新民
张勇
姚碧波
王起
易恒仲
Li Yao;Fang Zhe;Luo Danlin;Hu Yanmei;Tang Mi;Tang Zhigang;Wen Xinmin;Zhang Yong;Yao Bibo;Wang Qi;Yi Hengzhong(Hunan Chest Hospital,Changsha 410013,China)
出处
《中国防痨杂志》
CAS
CSCD
北大核心
2024年第6期687-698,共12页
Chinese Journal of Antituberculosis
基金
湖南省科技厅临床医疗技术创新引导项目(2020SK50702)
长沙市自然科学基金(kq2208097,kq2208096)
湖南省自然科学基金面上项目(2023JJ30335)
湖南省科技创新平台与人才计划(2018SK7003)。
关键词
结核
肺
冠状病毒感染
共病现象
疾病特征
预后
Tuberculosis,pulmonary
Coronavirus infections
Comorbidity
Disease characteristics
Prognosis
