2018 年第 8 期 第 13 卷

粟粒性肺结核与浸润性肺结核患者临床特点比较分析

Clinical characteristics of miliary pulmonary tuberculosis and invasive pulmonary tuberculosis

作者：张琪俞树青肖永久李玲义薛庆亮        

英文作者：

单位：730050兰州军区兰州总医院呼吸内科（张琪、肖永久、李玲义、薛庆亮）；730046兰州市肺科医院二病区（俞树青）

英文单位：

关键词：粟粒性肺结核；浸润性肺结核

英文关键词：

• 摘要：

• 【摘要】目的    比较粟粒性肺结核与浸润性肺结核患者临床特点，为临床诊治提供依据。方法    回顾性分析2007年1月至2016年1月在兰州市肺科医院及兰州军区兰州总医院住院诊断为粟粒性肺结核患者50例（粟粒性肺结核组）和浸润性肺结核患者60例（浸润性肺结核组）。比较2组患者临床表现和实验室指标检测结果。结果    粟粒性肺结核组发热比例高于浸润性肺结核组，咳嗽、咳痰、气短比例明显低于浸润性肺结核组［90.0%(45/50)比60.0%(36/60)、66.0%(33/50)比83.3%(50/60)、34.0%(17/50)比78.3%(47/60)、22.0%(11/50)比56.7%(34/60)］，差异均有统计学意义（均P＜0.05）。2组乏力、盗汗、消瘦、胸痛比例比较，差异均无统计学意义（均P＞0.05）。2组患者血小板计数、γ-谷氨酰转移酶、血清球蛋白、尿素氮、血肌酐、腺苷脱氨酶水平比较，差异均无统计学意义（均P＞0.05）。粟粒性肺结核组白细胞计数、中性粒细胞百分比、丙氨酸转氨酶、天冬氨酸转氨酶、总胆红素、直接胆红素、间接胆红素、C反应蛋白、红细胞沉降率水平明显高于浸润性肺结核组，红细胞计数、血红蛋白、总蛋白、血清白蛋白水平明显低于浸润性肺结核组，差异均有统计学意义（均P＜0.05）。结论    粟粒性肺结核患者发热、感染、炎性反应以及对肝肾功能的影响一般比浸润性肺结核患者严重，因此应加强抗结核药物的使用及支持治疗。    

• Objective    To analyze the clinical characteristics of miliary pulmonary tuberculosis and invasive pulmonary tuberculosis. Methods    Fifty cases of miliary pulmonary tuberculosis and 60 cases of invasive pulmonary tuberculosis diagnosed in Pulmonary Hospital of Lanzhou and Lanzhou Military Region General Hospital from January 2007 to January 2016 were retrospectively analyzed. Clinical manifestations and laboratory Results     were analyzed. Results    Proportion of patients with fever in miliary tuberculosis group was significantly higher than that in invasive tuberculosis group; proportions of cough, expectoration and shortness of breath in miliary tuberculosis group were significantly lower than those in invasive tuberculosis group［90.0%(45/50) vs 60.0%(36/60), 66.0%(33/50) vs 83.3%(50/60), 34.0%(17/50) vs 78.3%(47/60), 22.0%(11/50) vs 56.7%(34/60)］(P＜0.05). Proportions of fatigue, night sweat, emaciation and chest pain showed no significant differences between groups(P＞0.05). Levels of platelet count, γ-glutamyltransferase, serum globulin, urea nitrogen, creatinine and adenosine deaminase showed no significant differences between groups(P＞0.05). Levels of leucocyte count, neutrophil percentage, alanine aminotransferase, aspartate aminotransferase, total bilirubin, direct bilirubin, indirect bilirubin, C-reactive protein and erythrocyte sedimentation rate in miliary tuberculosis group were significantly higher than those in invasive tuberculosis group; levels of red blood cell count, hemoglobin, total protein, serum albumin in miliary tuberculosis group were significantly lower than those in invasive tuberculosis group（P＜0.05）. Conclusion    Symptoms of fever, infection, inflammatory response, liver and kidney dysfunction in patients with miliary pulmonary tuberculosis are more severe than those in patients with invasive pulmonary tuberculosis.