2021年新疆部分活动性肺结核发病特征分析

Analysis of the incidence characteristics of some active pulmonary tuberculosis patients in Xinjiang,2021

目的了解新疆部分活动性肺结核患者的发病特征,为制定肺结核防治策略提供科学依据。方法选取2021年1月—10月就诊于新疆医科大学第八附属医院呼吸与危重症科诊断为活动性肺结核的患者,采用描述流行病学方法分析患者的一般资料、临床表现、共病情况和影像学等资料。结果338例活动性肺结核患者平均年龄(51.68±19.93)岁,男女性别比1∶1.05,男性平均年龄(51.74±18.94)岁,女性平均年龄(51.62±20.89)岁,老年患者占33.73%;患者职业以农民、无业人员、退休人员为主;临床表现以咳嗽、咯痰、纳差、寐差、乏力、呼吸困难/胸闷气短、精神差、盗汗等为主;影像学以淡片状阴影/斑片影、结节灶/结节影、肺纹理增粗紊乱、空洞、胸膜增厚/粘连、高密度影、淋巴结肿大/钙化为主;共病以合并2型糖尿病、冠心病、高血压病、慢性支气管炎较为常见。结论新疆部分活动性肺结核患者临床表现不典型、影像学表现不典型、共病情况复杂;应引起各级诊断和防治人员高度重视,加强学习,提高鉴别诊断能力,最大程度地减少误诊率和漏诊率。

Objective To understand the incidence characteristics of some patients with active pulmonary tuberculosis in Xinjiang,so as to provide scientific basis for formulating prevention and treatment strategies of pulmonary tuberculosis.Methods The patients with active pulmonary tuberculosis diagnosed by the department of respiratory and critical care medicine of the eighth affiliated hospital of Xinjiang medical university from January to October,2021 were selected.The general data,clinical manifestations,comorbidities and imaging characteristics of the patients were analyzed by descriptive epidemiological methods.Results The average age of 338 patients with active pulmonary tuberculosis was(51.68±19.93)years,with the ratio of the male to the female of 1:1.05.The average age of the male and the female patients was(51.74±18.94)years and(51.62±20.89)years,respectively.The elderly patients accounted for 33.73%.The primary occupations of the patients were farmers,unemployed individuals,and retirees.The main clinical manifestations included cough,expectoration,anorexia,poor sleep,weak,dyspnea/chest tightness,poor mental status and night sweats.In terms of imaging manifestations,pale patchy shadows/patchy shadows,nodular foci/nodular shadows,lung markings thickening disorders,pulmonary cavity,pleural thickening/adhesions,high-density shadows,lymphadenectasis/calcification,and type 2 diabetes,coronary heart disease,hypertension,and chronic bronchitis were the common comorbidities.Conclusions Some patients with active pulmonary tuberculosis in Xinjiang have atypical clinical manifestations,atypical imaging manifestations,and complex comorbidities.The diagnostic and preventive personnel at all levels should pay high attention to strengthen learning and improve differential diagnosis ability,so as to furthest minimize the rate of misdiagnosis and missed diagnosis.