COPD长期应用糖皮质激素合并肺结核临床分析(附7例报告)

Clinic analysis of COPD with glucocorticoid in treatment tong time with pulmonary tuberculosis in elder patients(A report of 7 cases)

目的探讨老年慢性阻塞性肺病(COPD)长期应用糖皮质激素并发肺结核病的临床特点。方法回顾分析7例老年COPD长期应用糖皮质激素并发肺结核病的临床表现、X线和实验室检查及诊治情况。结果4例患者临床表现主要为不规则高热(57.1%),X线双肺均有广泛病变,抗酸杆菌阳性率57.1%,PPD试验阳性率28.6%。结论老年COPD长期应用糖皮质激素并发肺结核病的临床特点不典型,肺部病灶广泛,抗酸杆菌阳性率较高,PPD试验阳性率较低,死亡率较高,应尽早诊断和治疗。

To study clinic characteristic of COPD with glucocorticoid in treatment long time with pulmonary tuberculosis in elderly patients. Methods Retrospective analysis of 7 cases were performed and the clinic manifestations included X-ray, laboratory examination results, diagnosis and treatment conditions. Results 57. 1% （ n = 4） had irregular hyperpyrexia, two lungs showed with chest X-ray diplopulmonary lesion extensive, 57.1% had positive sputume smear, 28.6% had positive PPD, no cases showed strong positive, and 28.6% died. Conclusion These Patients have multiple clinic symptoms and their X-ray results show extensive damages. These patients have high positive rate of the sputum examinations, lower PPD positive rate. Thus, the fatality rate is high. We should seek for an early diagnosis and treatment for these patients.