老年肺结核诊断与治疗专家共识(2023版)

Expert consensus on diagnosis and treatment of elderly pulmonary tuberculosis

肺结核的发病率在老年人群中达到高峰。老年肺结核易漏诊、误诊,治疗成功率低,病死率高。未及时发现及有效治疗的老年肺结核患者是家庭、老年公寓和医院等人群集居场所的传染源。老年肺结核的严峻形势应引起医务人员尤其是呼吸科、感染科、老年病科医师的关注。制订和实施符合我国国情的老年肺结核诊断与治疗专家共识,对我国老年肺结核早期诊断、规范治疗、改善预后、降低传播风险至关重要。本共识内容包括老年肺结核的定义、流行病学特征及老年肺结核患者的免疫状态、危险因素、诊断及治疗等,并形成20条推荐意见供临床医师参考。

With the ageing of the population,the incidence of pulmonary tuberculosis in the elderly has peaked.Elderly patients with pulmonary tuberculosis are easily misdiagnosed.In terms of treatment,the elderly are characterized by low success rate of treatment and high mortality.In particular,elderly pulmonary tuberculosis patients who are not detected in time and treated effectively,are the source of infection in places where people congregate,such as nursing homes and hospitals.The seriousness of pulmonary tuberculosis in elderly deserves greater recognition from the medical staff,especially respiratory physicians,infectious disease physicians and geriatricians.It is important to formulate and implement expert consensus on diagnosis and treatment of elderly pulmonary tuberculosis in accordance with China′s national conditions in order to improve the early diagnosis rate of elderly pulmonary tuberculosis in China,standardize the treatment plan,improve the treatment outcome and to reduce the risk of transmission.This consensus covers the definition,epidemiology,immune status,risk factors,diagnosis and treatment of pulmonary tuberculosis in the elderly,and provides 20 recommendations for clinicians.