老年肺结核的诊断探讨  

To Explore of the Diagnosis of Pulmonary Tuberculosis in the Elderly.

作　　者：罗继征[1] 雷莉[1] 孟军英[1] 

机构地区：[1]北京军区总医院干二科,100700

出　　处：《中华临床医学杂志》2007年第1期7-9,共3页Chinese Journal of Clinical Practical Medicine

摘　　要：目的探讨老年肺结核的诊断要点。方法根据临床表现、伴随疾病、实验室检查及X线表现等方面对32例老年肺结核进行分析，并对非典型与典型肺结核进行2组对比分析。结果老年肺结核确诊时间长，非典型组长于典型组（P〈0．01）；多器官病变、COPD及肺部感染是最常见的伴随疾病，肺部感染及多器官病变的发生率非典型组高于典型组（P〈0．05）：PPD试验强阳性率及抗结核抗体阳性率较低：PPD阴性的发生率非典型组高于典型组（P〈0．05）：多肺段病变、空洞和／或钙化、纤维索条影、渗出性病变及胸膜改变的发生率高，胸膜改变的发生率非典型组高于典型组（P〈0．05）。结论老年肺结核不典型，病程长，诊断必须根据症状、实验室检查及X线表现综合判断：对于迁延不愈的多发肺部感染，伴胸膜改变应警惕结核的可能，条件允许应实施抗痨治疗。Objective To explore of the diagnosis of pulmonary tuberculosis（TB） in elderly. Methods 32 patients with pulmonary TB in the elderly were analyzed by the clinical symptom, complication, laboratory and X-ray. The contrast analyses were made in the atypical and typical TB. Results The time of the diagnosis was long and longer in the atypical TB than typical（P〈0.01）. The more organ diseases,COPD and lung infection were the most accompany ones. The incidence of the more organ diseases and lung infection was higher in the atypical TB than typical（P〈0.05）. The positive rate in PPD and TB antibody was low. The negative rate in PPD was higher in the atypical TB than typical（P〈0.05）. The incidence of the pathological changes of more lung segments, cavity, calcification, fibre film, effusion, pleura was high in X-ray. The incidence of pleura change was higher in the atypical TB than typical（P〈0.05）. Conclusion Pulmonary TB in the elderly was atypical and the course of disease long. The diagnosis is estimated by synthetic methedes. The possibility of TB was warned of repeated lung infections and pleura change. The antituberculotic therapy should be made in suitable condition.

关 键 词：结核 肺 诊断 老年人 

分 类 号：R521[医药卫生—内科学]