老年人与中青年人肺结核患者实验室检查的对比研究

Comparative study of laboratory examinations for elderly and young patients with pulmonary tuberculosis

目的收集老年组(≥60岁)及中青年人(18～59岁)肺结核患者的实验室检查结果,分析其是否存在差异。方法分成老年组肺结核患者159例和青中年肺结核患者255例,设计调查表,主要内容为抗酸染色结核分枝杆菌、结核菌素试验(PPD)、清结核抗体、红细胞沉降率(ESR)、血清蛋白电泳(SPE)等。结果老年组中痰涂片结核杆菌阳性23例(14.47%),明显多于中青年组11例(4.31%),2组比较差异有统计学意义(P<0.05),但2组血清结核抗体、ESR及SPE比较差异无统计学意义(P>0.05)。结论实验室检查针对肺结核多无特异性,无法早期准确诊断。老年肺结核痰涂片阳性率较中青年组高,但总体较低。ESR、血清结核抗体检查、SPE,对临床诊治有辅助作用,但缺乏特异性。结核菌素试验假阳性率高。

Objective Through collecting laboratory test results of elderly （ ≥60 years） and young（ 18-59） patients with pulmonary tuberculosis, to analyze if there were differences. Methods 159 elderly and 255 young patients were divided into two groups, elderly group and the young group. Questionnaire including Mycobacterium tu- berculosis acid - fast staining, PPD test, serum tuberculosis antibody, ESR and SPE were designed. Results Sputum culture positive rate for M. tuberculosis in elderly group（ 14.47% ） was higher than that in young group（4.31% ,P 〈0. 05）. There was no significant difference between two groups on serum tuberculosis antibody, ESR and SPE （ P 〉 0.05）. Conclusion Erythrocyte sedimentation rate, serum tuberculosis antibody test, serum protein electrophoresis, has a supporting role on the clinical diagnosis and treatment, even if the laboratory tests for tuberculosis has often non - specific.