维持性血液透析患者并发结核－附20例临床分析

Clinical investigation of tuberculosis in hemodialysis patients

作者对２０例血透３个月以上临床诊断并发结核的患者，与２０例同期行血透未并发结核的患者进行了Ｈｂ、血清白蛋白及ＫＴ／Ｖ平均值的比较。结果表明，结核组患者的Ｈｂ、血清白蛋白水平及ＫＴ／Ｖ值均低于对照组。指出临床上应高度重视血透期间的结核感染，并对其发病原因及治疗方法进行了讨论。

uberculosis infection (TB) was still amajor problem in the maintenance hemodial-ysis (HD) patients. In this study, we inves-tigated 20 HD patients who were diagnosedas TB infection (TB group) from Jan 1990 toJun 1994 in our center and compared thesepatients with other HD patients without TBaccording to sex,age and duration of HD (control group). The diagnosis was made ac-cording to clinical manifestations and re-sponse to antituberculosis treatment.Wefound that the incidence of TB in recentyears was 4.7%.Most patients had fever(85%),fatigue and nausea (100%).Fivepatients had pleural effusion, 3 patients hadlymphaden enlargement in the neck.Therewere pulmonary infiltration in 2 patients,preicardial effusion in 1 patient.Apart fromthese infection site, fouty five percent of thepatients had no obvious site of TB infec-tion. Blood hemoglobin and albumin levelwere much lower in TB group (5.99±0.87and 3.46±0.322 g/dl respectively) than incontrol group (77.11±1.441 and 4.03±0.29 g/dl respectively, P<0.01). MeanKT/V valuae less than 1.0 was seen in 68.8% of TB patients, wheare 33.3% of con-trol group (P<0.05). It was concluded thatthe incidence of TB in hemodialvsis was stillhigher and the clinical manifestations wereless typical than general population.Highincidence of TB infection in HD patients wasassociated with poor nutritional states anddialys is inadequacy.