两个时期肾结核的临床比较

The comparative study of renal tuberculosis in two periods

目的:探讨近年来肾结核的流行病学和临床变化趋势。方法:对收治的842例肾结核患者,以1980年底为界,分为先期组和近期组进行临床比较。结果:两组患者分别:占同期泌尿外科住院人数的8.74%和1.95%(P<0.05);就诊年龄中位数为28岁、38岁;病程平均为33.6个月、45.9个月。尿频91.1%,66.0%;血尿82.6%、64.7%;伴发肺结核18.4%、12.3%;伴发膀胱结核37.2%、19.6%;伴发附睾结核47.0%、36.6%(以上各项均P<0.05);IVU检查阳性率分别为90.0%、85.9%。结论:肾结核发病率近年来明显下降,其典型临床表现比例降低,不典型肾结核病例呈明显增加趋势。

Objective： To investigate the epidemiologic trends and clinical characteristics of renal tuberculosis （RTB）. Methods：Clinical data of 842 cases of renal tuberculosis admitted in in our department from Jan. 1955 through Dec. 2001 were reviewed retrospectively and these patients were divided into two groups according the time period： group one from Jan. 1955 through Dec. 1980, group two from Jan. 1981 through Dec. 2001）. Results：RTB patients accouted for 8.74% （516/5903） and 1.95% （326/16700） of total patients in Urology in the same period respectively. The median of patient＇s age were 28 and 38 years old, the average course of disease were 33.6 monthes and 45.9 monthes respectively. The rate of urinary frequency were 91. 1% （470/516） and 66.5% （217/326）, hematourea 82.6%（426/516） and 64.7% （211/326）, lung tuberculosis 18.4% （95/516） and 12.3% （40/326）, bladder tuberculosis 37.2% （192/516） and 19.6% （64/326）, epididynsis tuberculosis 46.9% （117/ 249） and 36.6%（56/153）, positive finding in IVU 90.0%（243/381） and 85.9%（207/241） respectively. Conclusions：The incidence of RTB has obviously decreased in recent years, and the rates of typical clinical manifestations had also decreased, while atypical RTB cases have obviously increased.