慢性支气管炎合并结核病85例临床分析  

Clinical analysis of 85 cases with chronic bronchitis combined with pulmonary Tuberculosis

作　　者：胡涛[1] 刘跃建[1] 

机构地区：[1]四川省人民医院呼吸科,610072

出　　处：《临床肺科杂志》2006年第1期22-23,共2页Journal of Clinical Pulmonary Medicine

摘　　要：目的提高对慢性支气管炎合并结核病的诊断水平。方法对2001～2004四年中确诊为慢性支气管炎合并肺结核85例进行回顾性分析。结果男76人，女9人，年龄68．5±8．78岁。咳嗽、咳痰85例。低热28例，高热45例，体温正常12例。咯血12例。盗汗13例。心累、气紧56例。痰查抗酸杆菌阳性27例。结核菌素皮肤试验（PPD）阳性率46％，无强阳性。血沉〉25mm／h占70％。外周血白细胞〉10×10^9／L24例，中性白细胞〉78％54例。胸部X线征象包括炎性浸润、纤维硬结钙化灶、纹理增多、空洞、胸腔积液、粟粒型肺结核及多种形态混合灶，具有显著的三多（多部位、多形态、多病灶）特点。做纤维支气管镜检查5例，病理检查证实1例。结论由于慢性支气管炎合并肺结核的不典型性给临床诊断带来很大困难，加强对肺结核是常见病及两者合并特点的认识，反复送痰检，提高痰涂阳性率，查血沉，熟悉X线征象的三多特点，提高临床诊断水平。Objective To raise the level of the diagnosis of chronic bronchitis combined with pulmonary Tuberculosis. Methods 85 cases confirmed chronic bronchitis combined with pulmonary TB from 2001～2004 were analysed retrospectively. Results Of 85 cases,male 76,female 9,the mean age was 68.5±8. 78 years. There were 85 cases with cough and sputum. There were 56 cases with heart fatigue and short of breath. There were 28 cases with low fever（T〈38. 5℃ ） ,45 cases with high fever（T 〉 38.5）, 12 cases without fever. 12 cases with hemoptysis. There were 27 cases with positive sputum smear, The positive rate of PPD was 46% ,no cases showed strong positive. The rate of ESR〉25mm/h was 70%. White blood cell increased（〉10× 10^9/L） in 24 cases, neutrophiles 〉 78% in 54 cases. The signs of chest X-ray included inflammation infiltration, sclerotic fibrosis and calcification, increased ,cavity, plenral effution,and mixed type, The remarkable characters were the sings of poly-parts, poly-sharps, poly-focus. Conclusion The diagnosis of chronic bronchitis combined with pulmonary TB is difficult because of its atypicity,to enhance the recognition of pulmonary TB is a kind of common disease and the characteristics of this two combined diseases, sputum examed repeadly, to raise the positive rate of sputum examination. ESR examed regularly. To master the characteristics of “three-poly” of X-ray,to help enhancing the clinical diagnosis level.

关 键 词：慢性支气管炎 肺结核 结核菌素皮肤试验 纤维支气管镜检查术 

分 类 号：R562.21[医药卫生—呼吸系统]