青年和老年肺结核临床特征及肺结核影像学对比

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英文篇名：Comparison of Clinical Characteristics and Imaging Findings of Tuberculosis Between Young and Old Patients 作者：陈桦 英文作者：CHEN Hua;Department of Infection,Tongji Huangzhou Hospital,Huazhong University of Science and Technology; 关键词：肺结核 ; 青年 ; 老年 ; 临床特征 ; 影像学 ; 病变部位 英文关键词：pulmonary tuberculosis;;youth;;old;;clinical characteristics;;imaging;;pathological changes 中文刊名：JXUY 英文刊名：China Continuing Medical Education 机构：湖北省黄冈华中科技大学同济黄州医院感染科; 出版日期：2019-04-10 出版单位：中国继续医学教育 年：2019 期：v.11 语种：中文; 页：JXUY201910054 页数：3 CN：10 ISSN：11-5709/R 分类号：138-140

摘要

目的对比分析青年和老年肺结核的临床特征及肺结核影像学特点。方法选择2007年8月—2011年8月医院门诊就诊的248例肺结核患者,对其临床资料进行回顾性分析,按照年龄分为青年组(120例)和老年组(128例),对比两组患者的临床特征、影像学表现、病变部位及范围、合并症并发症情况。结果老年组的咳血、胸闷、厌食的发生率及合并症并发症发生率高于青年组(P <0.05),发热的发生率低于青年组(P <0.05),病灶累及右肺下野、左肺下野、多肺野病灶及双肺均受累的发生率高于青年组(P <0.05);老年组影像征象多为结节状阴影、球形或肿块状阴影、空洞、一侧一致性高密度影、胸膜肥阜,而青年组影像学表现相对单一,多为云絮状阴影及胸腔积液,两组差异具有统计学意义(P <0.05)。结论老年肺结核患者的临床表现及影像学表现较青年患者复杂,合并症并发症较多,需提高对其临床及影像学特征的认识,以实现肺结核的早期诊断与治疗。
        Objective To compare the clinical characteristics and imaging features of pulmonary tuberculosis in young and old patients. Methods 248 cases of tuberculosis were selected from August 2007 to August 2011. The clinical data were retrospectively analyzed. They were divided into youth group(120 cases) and elderly group(128 cases) according to age. The clinical features, imaging manifestations, lesion location and scope, complications of the two groups were compared. Results The incidence of hemoptysis, chest tightness, anorexia and complications in the elderly group were higher than those in the young group(P<0.05). The incidence of fever was lower than that in the young group(P<0.05). The incidence of lesions involving right lower lung field, left lower lung field, multiple lung field and both lungs in the young group was higher than that in the young group(P<0.05). The imaging signs of the elderly group were nodular shadow, spherical or mass shadow, cavity, unilateral consistent high density shadow and pleural fullness, while those of the young group were relatively single. Most of them were cloudy shadow and pleural effusion, and the difference between the two groups was statistically significant(P < 0.05). Conclusion The clinical manifestations and imaging manifestations of elderly patients with pulmonary tuberculosis are more complex than those of young patients, and complications are more frequent. It is necessary to improve the understanding of their clinical and imaging characteristics in order to achieve early diagnosis and treatment of pulmonary tuberculosis.

引文

[1]陈大川,王在义.肺结核诊断的研究进展[J].临床肺科杂志,2016,21(1):145-148.
    [2]高绪胜.老年肺结核免疫治疗研究进展[J].实用老年医学,2015,29(7):534-536.
    [3]高孟秋.《WS288-2017肺结核诊断》新标准中关于临床诊断患者判定的解析[J].中国防痨杂志,2018,34(3):243-246.
    [4]苏瑾文.肺结核的保护性免疫和免疫病理机制进展[J].中国热带医学,2015,15(5):635-639.
    [5]黄丽静,陈焯彬,韦永孜.肺结核患者病情严重程度与免疫功能受损程度的相关性研究[J].海南医学,2016,27(9):1424-1426.
    [6]梁林,林健.静脉注射利福平治疗老年肺结核患者影像学改变的影响分析[J].中国地方病防治杂志,2016,31(10):1194.
    [7]曹仕鹏,李春香,邱淑梗,等.老年慢性阻塞性肺疾病合并肺结核的临床特点及诊治体会[J].广西医学,2017,39(5):585-589.
    [8]宫国柱.52例老年肺结核患者X线胸片影像分析[J].中华实用诊断与治疗杂志,2015,29(4):412,414.
    [9]张玉,叶建君,杨成凤,等.2006-2015年湖北省老年肺结核疫情特征及变化趋势分析[J].中国防痨杂志,2017,39(2):213-216.
    [10]唐倩,潘琴琴,杨俊超,等.农村老年肺结核患者发现延误综合干预效果评价[J].浙江预防医学,2017,29(3):266-268.
    [11]刘莉云.老年肺结核不典型表现21例临床特点分析[J].中国药物与临床,2017,17(2):248-249.
    [12]王武章.老年肺结核影像学特点[J].实用老年医学,2015,29(7):532-534.