结核性胸膜炎患者196例临床流行病学特点及随访分析

Analysis on the clinical and epidemiological characteristics of 196 cases with tuberculous pleurisy and follow-up

目的：回顾性分析196例结核性胸膜炎患者的流行病学特点及规范治疗后的复发率。方法选取2009年1月至2013年6月收治的196例结核性胸膜炎患者，从患者来源、年龄、性别、发病部位进行评价，分析患者的临床治疗效果及随访记录复发情况。数据统计分析采用χ2检验。结果农村及流动人口占77.55%（152/196），城镇人口占22.45%（44/196）。男性占74.49%（146/196），女性占25.51%（50/196）。农村及流动人口与城镇人口中男性患者差异有统计学意义（χ2＝11.88， P＜0.05）。20岁以下占7.14%（14/196），21～40岁占31.63%（62/196），41～60岁占28.57%（56/196），61～80岁占27.55%（54/196），80岁及以上占2.04%（4/196）。单侧胸腔积液占90.82%（178/196），双侧胸腔积液占9.18%（18/196）。治疗过程中药物性肝损害发生率19.9%（39/196）。服药完成率100%，经规范治疗1年后均病情稳定，失访1例。所有患者共随访420个患者年，平均随访2.15患者年/人，复发率1.03%（2/195）。胸膜增厚患者占81.63%（160/196）。结论结核性渗出性胸膜炎以单侧为主，以农村及流动人口中青年居多。经规范治疗后2年内复发率低，易形成胸膜肥厚。

ObjectiveTo analyze the epidemiological characteristics on 196 cases with tuberculous pleurisy and the relapse rate after regulate treatment retrospectively.Methods196 cases with tuberculous pleurisy were selected from January, 2009 to June, 2013. We appraised the cases from the origin, age, gender pathogenic site, and analyzed patients’ clinic treatment effect and recorded the follow-up recurrence rate.χ2 test was adopted to analyze data statistics.ResultsAll of the cases, 77.55% （152/196） were from rural and nomadic population, and 22.45% （44/196） came from urban. 74.49% （146/196） were males and 25.51% （50/196） were females. There was statistical significance in male cases between rural and nomadic population and urban （χ2=11.88,P〈0.05）. 7.14% （14/196） were under 20 years old, 31.63% （62/196） were 21-40 years old, 28.57% （56/196） were 41-60 years old, 27.55% （54/196） were 61-80 years old and 2.04% （4/196） were above 80 years old. 90.82% （178/196） were hemithorax pleural effusion, and 9.18% （18/196） were bilateral pleural effusion. 19.9% （39/196） happened medicine hepatic lesion in therapeutic process. All of cases were finished overdose, and pathogenetic condition was stabled after one year therapy, one of them was drop out during follow-up. All patients were followed up for 420 patient-years. The average follow-up was 2.15 patient-years. The recurrence rate was 1.03% （2/195）. There were 81.63% （160/196） cases with pleural thickened.ConclusionThe tuberculous effusion pleurisy in unilateral is more common. Rural and nomadic population are the principal cases, and they are middle-aged in the majority. In addition, the recurrence rate is lower after standard therapy, and the pachynsis pleurae is easy to form within two years.