326例肾结核临床诊断分析

Clinical analysis of renal tuberculosis:report of 326 cases

目的:探讨肾结核的临床特点,提高对不典型肾结核的早期诊断。方法:回顾分析1981￣2001年间收治的326例患者的临床资料。结果:尿抗酸杆菌,聚合酶连反应结核菌检查阳性率分别为28.9%和42.3%。静脉尿路造影(IVU)、B超、CT、逆行造影诊断阳性率分别为85.9%。65.3%、81.5%、73.8%。结论:临床不典型肾结核病例增多。IVU仍然是肾结核诊断的首选影像学检查,CT对可疑病例有一定辅助诊断价值。IVU、CT联合实验室检查可提高不典型肾结核的诊断阳性率。

Objective：To discuss the clinical characteristics and study the diagnosis of renal tuberculosis （RTB）. To improve the diagnoais of atypical TB at early stage.Methods：The clinical data of 326 cases of RTB treated between 1981 to 2001 were reviewed. Resuits：Urinary frequency,hematuria,lumbodynia and odynuria were the most common symptoms.The positive results of acid-fast stains, urinary TB-PCR were 28.9% and 42.3%respectively.The diagnostic accuracy of urography,B-type, ultrasonography CT and retrograde pyeloureterography was 85.9% ,63.5% ,81.5% ,73.8% respcctively.Conclusion：The cases of typical TB is increasing,IVU is still the first choice for diagnosis and CT scan is helpful.Combined use of different means of diagnostic technique would help to assess the diagnosis of RTB,espeeiaUy in atypical cases.