支气管结核继发于肺结核的因素分析

Analysis of causes of secondary bronchial tuberculosis patients with pulmonary tuberculosis

目的探讨支气管继发于肺结核的因素。方法纤支镜检查肺结核患者224例,分为肺结核继发支气管结核组128例和单纯肺结核组96例,比较两组患者临床表现和纤支镜检查结果等方面特点。结果两组在性别、年龄、肺结核类型、胸部X线、CT表现、纤支镜下支气管树变化、PPD皮试和痰涂片抗酸杆菌阳性率等方面有差别P<0.01或P<0.01。结论支气管结核继发于肺结核主要与内分泌、咳痰效果、纵隔淋巴结结核浸润邻近支气管、痰排菌量、变态反应等因素有关。行纤支镜检查对支气管肺结核的诊治有决定意义。

Objective To investigate the causes of secondary bronchial tuberculosis in patients with pulmonary tuberculosis. Methods 224 cases with pumimonary tuberculosis by bronchofibroscopy are divided into two groups： 128 cases with bronchial tuberculosis accompanying pulmonary tuberculosis, 96 cases with pulmonary tuberculisis. Clinical and bronchoscopic feature are contrasted between two groups. Results There are significant differences （ P 〈 0. 05 or P 〈 0. 01 ） between two groups for sex, age, types of pulmonary tuberculosis, chest radiography and CTscan, pathological changes in bronchial tree observed by bronchoscopy, PPD test, smear-positive rate and so on. Conclusion Attack of bronchial tuberculosis in patients with pulmonary tuberculosis is related to factoes on endoerinopathy, productive couph, bronchial infiltration of lymph node tuberculosis in mediastinum, quantity of tubercle bacillus in sputum discharged, allergy. There is a decisive significance for the dianosis and treatment of bronchial tuberculosis coexisting with pulmonary tuberculosis by bronchosecpy.