维持性血液透析患者并发结核9例回顾性分析

The retrospective analysis of tuberculosis in nine patients undergoing mainte-nance hemodialysis

目的调查维持性血液透析患者并发结核的情况。方法采用回顾分析的方法复习2001～2004年228例维持性血液透析患者,分析了维持性血液透析患者并发结核的发病率、发病症状、发病部位,患者的KT/V、血浆白蛋白、血红蛋白的变化,以及治疗和转归。结果228例维持性血液透析患者中合并结核感染9例(3.95%),主要症状有消瘦、乏力、纳差、发热(100%)、咳嗽、咳痰(55.6%)。发病部位主要有肺结核(44.4%)、淋巴结结核(33.3%)。患者的KT/V值、血浆白蛋白、血红蛋白均降低。大部分患者抗结核治疗有效(88.9%)。结论维持性血液透析患者并发结核的机会增加,且多存在营养不良、贫血加重、透析充分性下降。一旦怀疑合并结核感染应高度重视尽早治疗。

Objective To analyse the occurrence of tuberculosis（TB） in patients undergoing maintenance hemodialysis （HD）. methods We retrospectively reviewed 228 patients undergoing HD from 2001 to 2004. Morbidity, symptoms, sites of TB, and the parameters of KT/V, hemoglobin, albumin were analyzed. Result The incidence of TB in HD patients was 3.95%. The symptoms included emaciation, lack of power, no appetite, fever（100%）,cough （55.6%）. Four 44. 4% patients＇ site of TB were in lung and 3（33.3%） were in lymphnode. The levels of KT/V, albumin and hemoglobin were decreased. Most of patients were sensitive to anti-TB agents with the total effective rate of 88.9%. Conclusion The incidence rate of TB in HD patients increased, and malnutrition, aggravation of anaemia and dialysis in sufficiency were found in TB patients. TB should be paged attention and treated promptly if suspected