支气管结核与肺结核患者临床特征分析  

Studies on Clinical Characteristics in Patients Endobronchial Tuberculosis and Pulmonary Tuberculosis

作　　者：侯会玲[1] 魏兵[1] 毕俊英[1] 袁靖[1] 聂秀红[1] 

机构地区：[1]首都医科大学宣武医院呼吸科

出　　处：《首都医科大学学报》2008年第5期640-642,共3页Journal of Capital Medical University

摘　　要：目的总结支气管结核的临床特征,以期提高诊断水平。方法对36例支气管结核患者与30例肺结核患者的发病年龄、性别、临床表现、X线胸片及痰涂片抗酸杆菌结果进行卡方检验。结果2组患者发病年龄≥60岁者差异无统计学意义。支气管结核多见于女性,其主要症状为咳嗽、发热、胸闷。X线胸片特点:片状影多于小斑片影,22.2%的患者胸片正常,病灶部位右肺多于左肺。痰涂片抗酸杆菌均呈阴性,支气管刷检全部为阳性。肺结核主要症状为咯血,胸片均有阴影,以小斑片影为主,病灶部位以左肺多见,痰涂片抗酸杆菌全部呈阳性。36例支气管结核患者镜下显示炎症浸润型占38.9%、干酪坏死型占33.3%、瘢痕狭窄型占19.4%、肉芽增殖型占8.3%。结论支气管结核好发于女性,胸片影像无特征,22.2%的患者胸片无异常,病灶右肺多于左肺。镜下病变以炎症浸润和干酪坏死型为主。支气管镜刷检是诊断支气管结核的最重要方法之一。Objective To summarize clinical feature of endobronchial tuberculosis and improve the diagnosis. Methods To compare age, gender, clinical symptoms, chest X-ray, and smear of sputum were searched for acid-fast bacilli in 36 cases with endobronchial tuberculosis and in 30 cases with pulmonary tuberculosis. The data were analyzed by Chi square. Results The onset age exceed sixty years old and no significant difference were found in the two groups. Female were often with endobronchial tuberculosis. Main symptoms of cndobronchial tuberculosis were cough, fever and chest distress. Chest X-ray shadow characteristic were lamellar more than patching. Chest X-ray of 22.2% （8/36） were normal. Focus of infected were in right lung more than left lung. Acid-fast bacilli were all negative in smear of sputum, but bronchial washings were all positive. Pulmonary tuberculosis had often hemoptysis and chest X-ray showed shadow of patching. Focus of infected were in left lung more than right lung. Acid-fast bacilli were all positive in smear of sputum. Bronchoscopy showed the rate of inflammatory filtration at 38.9% （14/36）, cheesy necrosis at 33.3% （12/36）, cicatricial constriction at 19.4% （7/36） and granulation hyperplasy at 8.3% （3/36）. Conclusion Endobronchial tuberculosis is predilection in female. Chest X-ray are no specific change as well as 22.2% are normal. Focus of infected are in right lung more than left lung. Under bronchoscope, the main changes are inflammatory infiltration and cheesy necrosis. Bronchoscopy is best diagnostic method.

关 键 词：支气管 结核 支气管镜 X线胸片 

分 类 号：R521[医药卫生—内科学]