老年血行播散型肺结核临床特征及转归分析

Clinical characteristics and outcome of elderly patients with disseminated pulmonary tuberculosis

目的：探讨老年血行播散型肺结核（ DPT）的临床特点及转归。方法入选2006年1月至2014年4月期间在北京老年医院感染疾病科进行治疗的DPT患者96例。根据年龄将所有患者分为两组：老年组（ n＝42）和非老年组（ n＝54）。回顾性分析两组患者的临床特点和转归。结果老年组患者合并症发生率显著高于非老年组（66．7％ vs 24．1％；P＝0．000）。与非老年组相比，老年组患者的结核菌素试验（ PPD）阳性率、血红蛋白含量和白蛋白含量均显著降低，而白细胞计数显著增加（P＜0．05）。老年组患者的误诊率显著高于非老年组（45．2％vs 24．1％；P＝0．029）。与非老年组相比，老年组患者的治愈率显著降低（52．4％vs 77．8％；P＝0．009），而死亡率显著增高（11．9％ vs 1．9％；P＝0．044）。结论老年DPT患者治愈率低，误诊率和死亡率高，临床应予以充分重视。

Objective To investigate the clinical characteristics and outcome of the aged patients with disseminated pulmonary tuberculosis （ DPT） .Methods A total of 96 patients with identified DPT admitted in our department from January 2006 to April 2014 were subjected in this study .According to their age , they were divided into the aged group （ n =42 ） and the non-aged group （n=54）.The clinical features and outcomes of 2 groups of patients were retrospectively analyzed .Results The aged group had a significantly higher incidence of complications than the non-aged group （66.7%vs 24.1%, P=0.000）.The positive rate of tuberculin purified protein derivative （ PPD） test, and the levels of hemoglobin and albumin were obviously lower in the former than in the latter group （P〈0.05）.Compared with the non-aged group, the patients of the aged group had significantly higher misdiagnosis rate （45.2%vs 24.1%, P=0.029）, lower recovery rate （52.4% vs 77.8%, P=0.009） and higher mortality （11.9% vs 1.9%, P=0.044）.Conclusion The aged DPT patients have lower recovery rate , higher mortality and misdiagnosis rate .Special attention should be paid to them in clinical practice .