163例住院老年结核病死亡患者临床特点分析

The clinical analysis of the hospitalized elderly patients died from tuberculosis

目的 分析163例住院老年结核病死亡患者的临床特点.方法 收集北京胸科医院2008年1月至2012年12月因结核病死亡的老年住院患者共163例,男132例,女31例,男∶女＝4.26∶1;平均年龄（78.09±7.285）岁,男（78.73±7.095）岁,女（75.39±7.579）岁.对患者的营养状况、影像学检查、痰菌结果、实验室检查及死亡原因等临床资料进行回顾性分析.结果 163例因结核病死亡的住院老年患者中,实验室检查显示贫血患者133例（81.60％,133/163）,低蛋白血症患者155例（95.09％,155/163）,血淋巴细胞减少患者82例（51.57％,82/159）,菌阳110例（70.97％,110/155）,菌阴28例（18.06％,28/155）.肺部病变超过4个肺野者79例（48.47％,79/163）.死亡的主要原因为慢性心肺功能不全47例（28.83％）、多脏器功能衰竭34例（20.86％）及肺结核病变快速进展27例（16.56 ％）.结论 老年结核病死亡患者多存在营养状况差、多脏器功能衰竭及肺部病变重等症状.

Objective To analyze the clinical features of hospitalized elderly patients died from tuberculosis. Methods The information was collected in 163 inpatients died from tuberculosis admitted in Beijing Chest Hospital affiliated to Capital Medical University from Jan. 2008 to Dec. 2012. Of 132 cases were males and 31 cases were fe- males. The ratio of male and female was 4.26 ： 1. The average age was （78. 09±7. 285） years old in all patients, （78.73 ± 7. 095） years old in male and （75.39± 7.579） years old in female, respectively. The nutritional status, ra- diographic characteristics, laboratory examination including sputum results, the cause of death and the other clinical data were retrospectively analyzed. Results Laboratory tests showed anemia in 133 cases （81.60%, 133/163）. Most patients suffered from hypoalbuminemia and lymphocytopenia（95.09%, 155/163）. Of 110 cases were smear positive （70.96%, 110/155） and 28 cases were smear negative （18.06%, 28/155）. Lesions scattered more than 4 lung fields in 79 eases（48.47%, 79/163）. The main causes associated death were chronic function failure of the heart and lung（28.83 %, 47/163）, multiple organ failure （20.86%, 34/163） and pathological deterioration in lung disease（16.56%,27/163）. Conclusion The elderly patients died from tuberculosis is associated with malnutrition, multiple organ failure and lung disease exacerbations.