肺结核感染合并慢性阻塞性肺疾病患者的临床分析

Clinical Analysis of Patients with Tuberculosis Infection and Chronic Ob-structive Pulmonary Disease

目的探讨分析肺结核(TB)感染合并慢性阻塞性肺疾病(COPD)患者的临床特点,指导诊治疗二者合并症的临床观察。方法方便选取2015年1—12月该院收治的TB感染合并COPD患者及单纯TB患者各120例,研究其基础资料、临床表现、实验室检查结果、影像学检查结果,从而分析TB合并COPD患者的临床特点。结果 COPD合并肺结核组胸闷、胸痛、气喘、乏力、盗汗发生率多于单纯肺结核感染组(65.83%/10.00%,61.67%/10.00%,75.83%/55.00%,45.00%/5.83%,33.33%/4.17%),比较差异有统计学意义(P<0.05);PPD阳性、痰涂片查抗酸杆菌阳性TB组高于COPD合并TB组(39.17%/19.17%,70.83%/23.33%),但血电解质紊乱、低氧血症、Ⅱ型呼吸衰竭TB组低于TB合并COPD组(10.00%/27.50%,8.33%/20.83%,4.17%/13.33%),比较差异有统计学意义(P<0.05);肺炎X线表现、合并空洞症状TB组发生率高于COPD合并TB组(94.17%/41.46%,66.67%/27.50%),不同程度肺气肿、胸膜粘连或肋膈角变钝症状COPD合并TB组发生率高于TB组(100.00%/76.67%,32.50%/8.33%),比较差异有统计学意义(P<0.05)。结论随着COPD患者的逐年增多,COPD合并TB患者也在逐渐增多,应引起重视,加强COPD患者的结核病筛查,及时诊断并注意个体化治疗,绝大部分患者均可获得良好的预后。

Objective To d iscu ss th e c l in ic a l fe atures of p a t ien ts with tu b e rcu lo s is in fe ct ion an d ch ro n ic o bs tru ct iv e p u l -monary disease. Methods 120 cases of p a t ien ts with TB in fe ct ion an d COPD an d 120 c a se s of p a t ien ts with TB adm it ted and treated in our hospi tal from January 2015 to December 2015 were convenient selected and the basic data, cl inical mani-festations, laboratory examination results and imaging examination results were researched thus analyzing the cl inical fea-tures of pat ients with TB and COPD. Results The in c id e n c e ra te of d yspn ea , ch e s t p a in , asthm a, weak an d night swear in the complicat ion group was higher than that in the simple group （65.83%/10.00%, 61.67%/10.00%, 75.83%/55.00%, 45.00%/ 5.83%, 33.33%/4.17%） , and the differences had stat is t ical signif icance （P〈0.05）, and the PPD positive and positive sputum smear for acid-fast baci l l i in the complicat ion group were higher than that in the simple group （39.17%/19.17%,70.83%/ 23.33%） , but the blood electrolyte disorder , hyoxemia and respiratory failure in the complicat ion group were lower than those in the simple group（10.00%/27.50%,8.33%/20.83%,4.17%/13.33%） , and the differences had stat ist ical signif icance（P〈 0.05）, and the incidence rate of X-ray manifestat ions of pneumonia and cavity in the simple group was higher than that in the complicat ion group （94.17%/41.46%,66.67%/27.50%）, and different degrees of emphysema, pleural adhesion or blunt Har rison angle in the complicat ion group were higher than that in the simple group（100.00%/76.67%,32.50%/8.33%） , and[ ] 1 9 5 8 .8the difference had stat is t ical signif icance （P〈0.05）. Conclusion With th e g rad u al in c re a se of COPD p a t ien ts , th e p a tien ts with COPD and TB gradually increases , and we should pay at tent ion to them, and most pat ients can obtain good prognosis by enhancing the tuberculosis screening of COPD pat ients and not ice the individual treatment in time.