老年慢性阻塞性肺疾病合并肺结核50例调查分析

【摘要】 目的调查分析老年慢性阻塞性肺疾病(COPD)合并肺结核患者特点、延误诊断原因,提示临床医生重视COPD合并肺结核,早诊断、早治疗。方法对天津市海河医院2000年～2010年收治的50例老年COPD合并肺结核患者进行回顾性调查分析。结果 (1)COPD病史较长(2)无特征性临床表现(3)影像学表现不典型(4)易合并细菌感染及混合菌感染(5)结核菌素试验常呈阴性(6)漏、误诊比率68%(34/50)(7)肺部感染以革兰氏阴性杆菌为主(8)吸烟的患者较多(9)不同程度应用激素,而且以静脉和口服病例较多(10)肺功能多属中、重度改变,全身不良反应及机体免疫力受到不同程度影响。结论 (1)老年COPD合并肺结核患者临床症状不显著、X线表现不典型、结核菌素试验呈阴性或弱阳性反应,不能完全除外结核病可能(。2)根据病原菌及药敏选择抗生素及给予合理的个体化抗痨治疗多数能达到较好的转归(。3)主张应用吸入激素作为巩固期治疗措施。更多还原

【Abstract】 Objective To investigate and analyse old-age chronic obstructive pulmonary disease(COPD) merge tuberculosis sufferer’s characteristics,delay diagnosis reason,hint that the clinical doctor mergings tuberculosis combine with COPD sufferer to spark a respect and hit the purpose that diagnosed and cured in early days.Methods Investigate 50 cases of elderly patients who suffer from COPD complicated with pulmonary tuberculosis in Tianjin haihe hospital from 2000 to 2010,Results(1) COPD disease history is longer;(2)The clinical outbreak has no character to express;(3)The image learns a performance anti typical model;(4) Easily merging germ infection and mix germ infection;(5)The tubercle germ vegetable test often presents feminine gender;(6)The leak,misdiagnosis ratio is68%(34/50);(7)The lung is often infected with the Ge orchid surname feminine gender rod bacteria for lord;(8) Smokes cigarette more;(9)The different degree applies hormone history,and with vein and take orally more;(10)Lung function majority are belonging to,the heavy degree transform and badly respond all over and the air frame immunity force is subjected to different degree impact.Conclusion(1) The clinical symptoms is not obvious in elderly patients with COPD complicated with pulmonary tuberculosis,X-ray is not typical,tuberculin test Were negative or weakly positive reaction,.It is also incapability complete excepted the possibility of tuberculosis.(2) According to the choice of antibiotic sensitivity test and give reasonable individualized anti-tuberculosis treatment most can achieve good outcome.(3) The inhaled hormone application for consolidation.更多还原