老年肺结核的诊治现状与进展

The status and progress of diagnosis and treatment for elderly patients with tuberculosis

我国是全球22个结核病高负担国家之一，全国第五次结核病流行病学抽样调查结果显示，活动性肺结核患者中，60岁以上的患者占48．8％。老年肺结核的临床症状及影像学表现不典型、并发症及合并疾病多、一些实验室检查阳性率低、药物不良反应发生率高、治疗效果及转归差，使其成为结核病控制的难点与挑战。近年来，我国老年人已被列为肺结核筛查的重点人群，一些新的分子生物学及免疫学方法用于结核病的辅助诊断，针对老年结核病患者的个体化治疗和综合治疗得到关注，为老年结核病的诊治提供了技术支撑。

China is one of the twenty two high burden countries of tuberculosis （TB） in the world. The titth national epidemiological sampling survey of TB showed that the patients aged over 60 accounted for 48.8% in the patients with active TB. The diagnosis and treatment of the elderly patients with TB is the huge challenge for TB control because of atypical symptoms and imaging findings, many complications, low positive rate in the laboratory test, relatively high rate of adverse drug reactions and unsatisfactory therapeutic effect and outcome, etc. In recent years, the elderly have been listed as the focus group of TB screening in China. Some new molecular biological and immunological methods have been used in TB diagnosis. The individual and comprehensive treatment for the elderly patients with TB has been got more attention. All the measures above provide technical support fo~ the diagnosis and treatment of TB in elderly patients.