2012-2016年北京市胸科医院肺结核合并症患者的回顾性分析

A retrospective study of pulmonary tuberculosis co-morbidities in Beijing Chest Hospital,2012-2016

目的对北京市胸科医院住院肺结核患者合并症情况进行回顾性分析,为改善结核病的诊断和治疗提供参考。方法收集于2012-2016年间初次住院的艾滋病病毒抗体检测阴性、年龄>15岁的肺结核患者的病历资料,分析肺结核合并症谱、主要合并症的时间、人群分布特征。结果共纳入初次住院的肺结核患者9 653例。8种肺结核合并症包括营养不良(19.49%,1 881/9 653)、2型糖尿病(19.18%,1 851/9 653)、贫血(16.70%,1 612/9 653)、白细胞减少症(3.53%,341/9 653)、病毒性肝炎(3.46%,334/9 653)以及与呼吸系统相关的肺癌(1.65%,159/9 653)、慢性阻塞性肺疾病(1.61%,155/9 653)、矽肺(0.81%,78/9 653)均为老年组(≥60岁)高于中青年组(<45岁和45~59岁)(P<0.05);男性组高于女性组(P<0.05);除白细胞减少症和病毒性肝炎外,其他均为无业组高于在职组(P<0.05)。结论该结核病专科医院肺结核的主要合并症为营养不良、2型糖尿病、贫血。男性、年龄≥60岁的肺结核患者易出现合并症。应规范肺结核合并症患者的诊疗研究,提高对复杂肺结核病的诊断治疗水平。

Objective To analyze the prevalence of pulmonary tuberculosis（PTB）co-morbidities in hospitalized patients in our hospital and provide references for the prevention and treatment of PTB. Methods The clinical data of HIV negative PTB patients aged15 years and hospitalized for the first time in our hospital from2012 to2016 were collected. The PTB comorbidity spectrum,time distribution and population characteristics of major co-morbidities were analyzed. Results A total of9 653 PTB patients were enrolled. The proportion of Malnutrition（19.49%,1 881/9 653）,typeⅡdiabetes（19.18%,1 851/9 653）,anemia（16.70%,1 612/9 653）,leukocytopenia（3.53%,341/9 653）,viral hepatitis（3.46%,334/9 653）and co-morbidities related to respiratory system like lung cancer（1.65%,159/9 653）,chronic obstructive pulmonary disease（1.61%,155/9 653）,silicosis（0.81%,78/9 653）were all higher in elderly group（≥60 years old）than in middle-youth age group（45 and45-59 years old）（P〈0.05）;Also higher in male group than in female group（P〈0.05）;Except for leukocytopenia and viral hepatitis,the prevalence of other co-morbidities were higher in jobless people than in-service staff（P〈0.05）. Conclusion TypeⅡdiabetes,malnutrition and anemia were the most common co-morbidities in PTB patients.Male and≥60 years old PTB patients were often affected by co-morbidities. It is necessary to standardize the diagnosis and treatment management of PTB patients and effectively improve the diagnosis and treatment level of PTB patients complicated with other diseases.