128例菌阳肺结核临床特点分析

Analysis of clinical characteristics of 128 cases of sputum positive pulmonary tuberculosis

目的探讨某院菌阳肺结核病例临床表现特点,为菌阳肺结核的诊治提供依据。方法收集某院同期复治菌阴60例和菌阳128例活动性肺结核病例临床资料,并进行回顾性分析。结果菌阳组血清腺苷脱氨酶(adenosine deaminase,ADA)升高率、血沉(erythrocyte sedimentation rate,ESR)增快率分别为14.8%、93.8%,高于菌阴组的3.3%、60.0%,差异有统计学意义(P<0.05)。菌阳组双侧肺叶和3个肺野以上的受累率分别为69.5%和39.8%,高于菌阴组的38.3%和10.0%,差异均有统计学意义(P<0.05)。菌阳组空洞病灶发生率明显高于菌阴组(P<0.05),不同年龄组耐药率有随年龄增长而下降的趋势,差异均有统计学意义(P<0.05)。乙胺丁醇单耐药率最高(26.4%),含链霉素的耐多药率最高(19.4%)。结论某院菌阳肺结核肺叶受累严重,血液临床检验结果异常比例高。

Objective To explore the clinical characteristics of sputum positive pulmonary tuberculosis to provide basis for diagnosis and treatment of bacillus positive pulmonary tuberculosis. Methods The clinical data of 60 sputum negative pulmonary tuberculosis cases and 128 sputum positive pulmonary tuberculosis cases were collected and retrospectively analyzed. Results The speeding rates of serum adenosine deaminase（ ADA） and erythrocyte sedimentation rate（ ESR） were 14. 8% and 93. 8% respectively,of patients with sputum positive pulmonary tuberculosis,which were higher than that of patients with sputum negative pulmonary tuberculosis,which were 3. 3% and 60. 0%,and the difference was statistically significant（ P〈0. 05）. The involvement of bilateral lungs and patients with more than 3 lung fields involved in the sputum positive pulmonary tuberculosis group accounted for 69. 5% and 39. 8%,which were higher than that in the sputum negative pulmonary tuberculosis group with 38. 3%and 10. 0%,and the difference was statistically significant（ P〈0. 05）. The incidence rate of cavity lesions of sputum positive group was significantly higher than of bacterial negative group 30. 0%,and the difference was statistically significant（ P〈0. 05）. Drug resistance rates in different age groups tended to decrease with age,and the difference was statistically significant（ P〈0. 05）. The highest resistance rate of ethambutanol was 26. 4%, and the multidrug resistance rate of streptomycin was19. 4%. Conclusion The sputum positive pulmonary tuberculosis patients were serioudly affected,and the proportion of blood test abnormity were high.