与糖皮质激素相关的单纯初治肺结核54例临床分析

Relations of pulmonary tuberculosis on primary simple therapy with Glucocorticoids: clinical analysis of 54 cases

目的探讨在抗结核治疗前糖皮质激素对单纯初治肺结核病变的影响。方法收集 5 4例在抗结核治疗前有明确长期应用糖皮质激素史的单纯初治肺结核 ,对其临床症状、实验室检查、X线检查及疗效进行回顾性分析。结果本组临床症状明显但不典型 ,痰集菌阳性率高 ,转阴时间长。病灶多呈恶化状态 ,并伴有支气管播散灶 ,吸收缓慢。结论单纯初治肺结核在正规抗结核治疗前应用糖皮质激素者并发症多 ,治疗困难。故临床应慎用糖皮质激素 。

Objective To delve further into effect of glucocorticoids on lesion of pulmonary tuberculosis prior to administration of antituberculotics. Methods Totally,54 cases of pulmonary tuberculosis without any complication but definite useage of glucocorticoids were selectec prior to administration of antituberculotic drugs.A retrospective analysis was performed on their clinical symptoms,laboratory tests,chest X ray examinations and effectiveness. Results Clinical symptoms of the patients in this study were distinct but not typical;sputum positivity for tubercle bacilluses was high;it took a much longer period of time for them to have it negated. Mostly,the tuberculous focuses became extensive and deteriorative always with bronchogenic dissemination and poor absorption of the lesions. Conclusions The usage of glucocorticoids prior to antituberculotic drugs produced poor responses for pulmonary tuberculosis on primary therapy and high prevalance of complications.