结核门诊发现初治肺结核患者并发肺部其他感染的特点分析

Analysis of characteristics of pulmonary tuberculosis patients complicated with other pulmonary infections in tuberculosis outpatient

目的了解结核专科门诊发现肺结核初治患者并发肺部其他感染现状,分析其临床特点。方法回顾性分析2017年1月—2018年1月在我院结核专科门诊就诊、临床资料齐全的初治肺结核患者300例,根据患者就诊时是否并发肺部其他感染,分为观察组和对照组。观察组120例为肺结核并发肺部其他感染患者,对照组180例为未并发其他感染患者,对比2组的临床资料,包括年龄、性別、临床症状、痰结核分枝杆菌培养及影像学检查结果。结果2组男性比例、伴有咳嗽或咳痰症状者比例差异均无统计学意义(P>0.05);观察组老年患者比例、痰菌阳性者比例、肺部累及病灶>3个肺野者比例、肺结核并发空洞者比例高于对照组,差异均有统计学意义(P<0.05)。结论结核专科门诊发现肺结核初治并发肺部其他感染患者中,老年患者的比例较高,且患者肺部病灶累及范围较广泛,痰菌培养结核分枝杆菌多呈阳性,常伴有空洞形成,应引起临床重视。

Objective To explore the current status of pulmonary tuberculosis patients with other pulmonary infections in tuberculosis outpatient,and analyze the clinical characteristics of pulmonary tuberculosis patients with other pulmonary infections.Methods From January 2017 to January 2018,a total of 300 newly diagnosed pulmonary tuberculosis patients with complete clinical data who visited the Tuberculosis Outpatient of the First People's Hospital of Fangchenggang were retrospectively analyzed.The patients were divided into two groups:observation group and control group according to whether they presented other pulmonary infections during the visit.There were 120 patients in observation group,namely pulmonary tuberculosis complicated with other pulmonary infections,and 180 patients in control group,namely pulmonary tuberculosis not complicated with other infections.The clinical data of patients from two groups at admission,including age,gender,clinical symptoms,sputum culture of mycobacterium tuberculosis and imaging examination results were explored.Results①Patients from the two groups were both mainly males.The proportion of males(χ2=3.599,P=0.058)was compared with the proportion of those with cough or expectoration(χ2=1.751,P=0.186)in the two groups and the differences were not statistically significant.②Among patients from the two groups,the proportion of male patients(χ2=5.284,P=0.022),the proportion of those with smear-positive(χ2=35.746,P=0.000),the proportion of those with involved pulmonary lesions over 3 lung fields(χ2=11.084,P=0.001)and the proportion of those with pulmonary tuberculosis and cavitation(χ2=9.212,P=0.002)were compared and the differences were all statistically significant.Conclusions The proportion of elderly patients with other pulmonary infections was higher among the patients with primary pulmonary tuberculosis with other pulmonary infections found in the special tuberculosis outpatient.The patients with other pulmonary infections had a wider range of pulmonary lesions.The sputum cultured mycobacterium tuberculosis was mostly positive,and often accompanied by cavity formation.