支气管哮喘合并肺结核病回顾分析

Retrospective analysis of bronchial asthma patients complicated with pulmonary tuberculosis

目的探讨支气管哮喘与肺结核病例的相关性,提出临床诊断与治疗措施。方法回顾2000～2007年收治的88例以支气管哮喘为主要表现肺结核病例的诊断及治疗过程,总结临床体会,临床诊断与治疗措施。结果支气管哮喘与肺结核互为发病因素;以哮喘为主要表现肺结核病例,因支气管哮喘症状,使肺结核有很大的隐蔽性,易发生误诊。本组治疗过程误诊率达81.8%;以支气管结核及非典型部位结核居多,占64.8%。抗结核治疗上应以敏感的杀菌药为主组成合理化疗方案,控制结核病,缓解哮喘症状。激素应用以短期小剂量及吸入为主原则,避免结核病加重或扩散。结论支气管哮喘与肺结核有相关性,二者互为发病因素;治疗上以抗结核消除致喘因素为主,辅以短期小剂量激素治疗或激素吸入治疗,避免结核病加重或扩散。

Objective To study the correlation between bronchial asthma and tuberculosis. Methods 88 tuberculosis patients with main manifestation of bronchial asthma from 2000 to 2007 were retrospective analyzed. Results Bronchial asthma and tuberculosis interacted pathogenic factors. Tuberculosis cases with main manifestations of asthma were easily misdiagnosed. The misdiagnosis rate in this observation was 81.8% in which bronchial tuberculosis and atypical tuberculosis accounted for 64.8%. Effective antituberculosis drugs were used for rational chemotherapy for controlling tuberculosis and alleviating asthma symptoms. The use of corticosteroids should be in short term and low dose and mainly inhalated to avoid aggravating or spreading of tuberculosis. Conclusion Bronchial asthma and tuberculosis interacted and control asthma anticipated to antituberculosis treatment aided by use of short-term and low-dose corticosteroids or inhaled corticosteroids.