老年慢性阻塞性肺疾病合并肺结核感染临床特点分析

Clinical characteristics analysis of elderly patients with chronic obstructive pulmonary disease complicated with pulmonary tuberculosis infection

目的分析老年慢性阻塞性肺疾病合并肺结核感染的临床特点。方法选取2008年1月～2011年12月的老年慢性阻塞性肺疾病合并肺结核感染患者80例,研究其一般资料、临床表现、实验室检查结果、影像学检查结果,从而分析老年慢性阻塞性肺疾病合并肺结核感染的临床特点。结果 80例患者中以男性患者居多,吸烟患者居多,并同时伴有单纯性支气管炎、喘息性气管炎、支气管哮喘。临床表现主要有胸闷、咳嗽、气喘、胸痛、咳痰、呼吸困难等症状,部分患者出现低热、盗汗、乏力、咯血、食欲不振等症状。实验室检查结果显示,PPD阳性者有15例,痰涂片查抗酸杆菌阳性者有18例,血电解质紊乱者21例,低氧血症者16例,Ⅱ型呼吸衰竭者10例。影像学检查结果显示,80例患者均有不同程度的肺气肿,此外,双肺不同肺叶有均匀一致的斑片状阴影、类似肺炎X线表现的患者有33例,合并空洞症状的患者有21例,胸膜粘连或肋膈角变钝症状的患者有26例。结论老年慢性阻塞性肺疾病合并肺结核感染的临床特点复杂多样,医务人员应该根据患者的实际情况进行综合治疗,确保实现康复的目的。

Objective To analyze the clinical characteristics of elderly patients with chronic obstructive pulmonary disease complicated with pulmonary tuberculosis infection. Methods Eighty cases of elderly patients with chronic obstructive pul- monary disease complicated with pulmonary tuberculosis infection from January 2008 to December 2011 were chosen, the general information, clinical presentation, laboratory findings, imaging findings were studied, thus to analyze the clinical characteristics of elderly patients with chronic obstructive pulmonary disease complicated with pulmonary tuberculosis in- fection. Results Among 80 cases of patients, male and smoking patients were more, and accompanied with bronchitis, asth- matic bronchitis, bronchial asthma patients. The main clinical manifestations were chest tightness, cough, asthma, chest pain, sputum, difficulty breathing and so on, part of patients had low heat, night sweats, lack of power, coughing up blood, loss of appetite and other symptoms. Laboratory examination results showed PPD positive were 15 cases, the sputum smear examination to check acid-bacteria bacilli positive were 18 cases, blood electrolyte disturbance were 21 cases, hypoxemia were 16 cases, type I1 respiratory failure were 10 cases. Imaging examination results were shown that, 80 patients had dif- ferent degree of emphysema, in addition, two different lung lobe had uniform patchy shadows, 33 cases of patients were similar to chest X-ray manifestations, 21 cases were combined with hollow symptoms in patients, 26cases were pleural ad- hesions or rib diaphragm angle blunted symptoms in patients. Conclusion The clinical characteristics in elderly chronic obstructive pulmonary disease complicated with pulmonary tuberculosis infection arc complexity and diversity, the medical staff should give the comprehensive treatment for the patients based on the actual situation, to ensure the realization of the purpose of rehabilitation.