慢性肾功能衰竭血液透析患者合并结核感染的诊治

Tuberculosis in Patients with Chronic Renal Failure Undergoing Hemodialysis

目的分析慢性肾功能衰竭(CRF)血液透析患者合并结核感染的诊断和治疗的特点,以期早期诊治。方法回顾性分析13例CRF规律血液透析患者合并结核感染的临床表现、实验室检查特点及抗痨治疗反应。结果结核感染的发生率为4.2%,23.1%有结核病史;肺外结核占76.9%,其中胸膜结核最为常见(30.8%);PPD试验阳性率55.6%,抗结核抗体的阳性率仅为11.1%;多数病例对抗结核药物反应良好,治疗总有效率为84.6%。结论CRF血液透析患者合并结核感染时肺外结核发生率高,临床表现不典型,实验室检查敏感性低,应加强监测争取早期诊断早期治疗。

Objective To improve the level of early diagnosis and outcome of tuberculos is(TB)in patients with chronic renal failure on regular hemodialysis(HD).Me thods Thirteen cases among306patients un dergoing HD from January1995to May2000were identified,and the clinical presentations,dia gn-ostic procedu res and management were analyzed.Results The incidence of TB in HD patients wa s4.2%.The extrapulmonary TB is common,accounting for76.9%.The main s ite of TB was pleural in4(30.8%)patients.Most of patients were sensitiv e to anti-TB agents with the total effective rate of84.6%.Conclusions The TB should be diagnosed carefully and treated promptly if suspected in pat-ients with CRF during the period of HD.