17例由结核分枝杆菌引起的结节性红斑临床分析

Clinical analysis of 17 patients of erythema nodosum caused by Mycobacterium tuberculosis

目的通过总结由结核分枝杆菌所导致结节性红斑的病例特点,进一步指导临床诊疗。方法收集2010年1月-2016年6月在天津市海河医院就诊治疗的17例由结核分枝杆菌感染所致结节性红斑患者的临床资料,从临床表现特征、临床分型、检查指标、组织病理特点、治疗五个方面进行回顾性分析。结果 17例由结核分枝杆菌所导致的结节性红斑患者中,男:女=1:4.7,平均年龄32.5岁,结核病接触史者占64.7%;肺外结核的比例为7 0.5%,原发性肺结核占17.5%;各化验阳性比例:血沉(76.5%)、T-SPOT(70.6%)、胸部影像学(47.1%)、PPD(41.2%);经治疗后1 2例患者经治疗后红斑完全消失,5例红斑稳定。结论对结节性红斑患者应常规进行结核分枝杆菌感染的筛查,尽早给予抗结核治疗,以避免延误诊治。同时作好治疗预防工作,使患者早日治愈。

Objective The clinical characteristics of patients with erythema nodosum caused by Mycobacterium tuberculosis were summarized to direct the clinical treatment. Methods The clinical datas of 17 patients with erythema nodosum caused by Mycobacterium tuberculosis from January 2010 to June 2016 in Tianjin Haihe Hospital were collected and retrospectively analyzed from five aspects of clinical manifestation,clinical classification,examination index,histopathological features,treatment. Results In all patients,the ratio of male to female wa s 1：4.7,the average age wa s 32.5,the cases of tuberculosis contact history was 64.7%,the cases of extrapulmonary tuberculosis wa s 70.5%,the cases of primary pulmonary tuberculosis wa s 17.5%. Positive ratio of every test：ESR（76.5%）,T-SPOT（70.6%）,chest imaging（47.1%）,PPD（41.2%）;After treatment,erythema nodosum in 12 patients were completely cured with 5 cases were stable. Conclusion Routinely screening of mycobacterium tuberculosis infection should be performed for patients with erythema nodosum,and then early treatment should be given to the confirmed patients to avoid delay in diagnosis and treatment. At the same time,it＇s necessary for the patients＇ earlier cure to do a good job on the diagnosis and prevontion.