诊断性治疗确诊的79例结核病患者的临床分析  

Clinical analysis of 79 cases with atypical tuberculosis proved by diagnostic therapy

作　　者：张雅楠[1] 刘卫[1] 张文静[1] 殷萌 贺永文[1] 

机构地区：[1]华中科技大学同济医学院附属协和医院感染性疾病科,武汉市430022 [2]新疆博尔塔拉蒙古自治州人民医院感染科

出　　处：《中华实验和临床感染病杂志（电子版）》2014年第5期47-49,共3页Chinese Journal of Experimental and Clinical Infectious Diseases(Electronic Edition)

摘　　要：目的分析不典型结核分枝杆菌感染的特点,以提高结核病的临床诊断水平。方法回顾性分析武汉协和医院2005年1月至2012年12月收治的以发热为主要表现并且经诊断性抗结核治疗确诊的79例结核病患者的临床资料。结果本组患者均以发热为主要临床表现,而午后潮热、盗汗和消瘦等结核分枝杆菌感染的临床症状多不明显。其中多数患者的检查结果显示如下特点:白细胞计数多正常或降低(占84.8%),超敏C-反应蛋白升高(占84.0%),红细胞沉降率增快(占73.0%),糖蛋白抗原125(CA125)不同程度升高(占74.3%),影像学检查多提示浆膜腔积液或者淋巴结肿大(占44.3%)。目前临床常用的结核分枝杆菌感染的血清标志物检测价值有限。结论具备以上临床特点的发热患者需考虑结核分枝杆菌感染的可能,诊断性抗结核治疗有助于该病的确诊。Objective To investigate the clinical characteristics and diagnosis methods of atypical tuberculosis. Methods The clinical data of atypical tuberculosis patients with fever proved by diagnostic therapy from January 2005 to December 2012 in Wuhan Union Hospital were analyzed, retrospectively. Results The major clinical manifestation was fever, but tidal fever in the afternoon, fatigue, and weight loss were not common. The leukocyte counts were mostly normal or low（84.8%）. Almost half of the patients showed elevated high sensitive of C-reactive protein（84.0%）, erythrocyte sedimentation rate（73.0%） and carbohydrate antigen 125（CA125）（74.3%）. Polyserositis or lymphadenopathy was found in most of the patients（44.3%）. At the present, serological tests had limited value in the diagnosis of tuberculosis. Conclusions The diagnosis of tuberculosis should be considered on patients with the above clinical characteristics. Therapeutic trial could provide correct diagnosis.

关 键 词：结核 感染 发热 

分 类 号：R52[医药卫生—内科学]