苏州地区2011年——2017年间9528例肺结核患者合并症的原因分析及其分布趋势  

Analysis on Cause and Distribution Tendency of Complications of 9528 Patients with Pulmonary TB in Suzhou Area from 2011 to 2017

作　　者：姚琳 顾斌斌 王霞芳[1] 沈兴华[1] 张建平[1] 包紫薇[1] 时翠林[1] 沈颖杰 唐佩军[1] 吴妹英[1] VAO Lin;GU Bin-bin;WANG Xia-fang;SHEN Xing-hua;ZHANG Jian-ping;BAO Zi-wei;SHICui-lin;SHEN ying-jie;TANG Pei-jun;WU Mei-ying(The No. 5 People's Hospital of Suzhou, Suzhou Jiangsu 215007, China)

机构地区：[1]苏州市第五人民医院,江苏苏州215007

出　　处：《抗感染药学》2019年第2期258-261,共4页Anti-infection Pharmacy

基　　金：苏州市临床重点病种诊疗技术专题项目(编号:LCZX201514);苏州市科技局民生科技项目(编号:SS201656;SYS201778;SS201880;SYS2018096);江苏省青年医学人才项目(编号:QNRC2016226)

摘　　要：目的:分析苏州地区住院肺结核患者的合并症原因及其分布趋势,为改善结核病的诊断和治疗提供参考。方法:收集2011年-2017年间收治的肺结核患者9 528例病历资料,并发症6 927例,其中肺外结核和咯血患者设为青少年组(n=4 389例),糖尿病、耐药、药物反应患者设为中老年组(n=2 538例);分析其肺结核合并症谱、时间和年龄分布的趋势。结果:6 927例住院肺结核并发症患者占肺结核患者的72.70%;肺结核合并症如肺外结核3 453例、糖尿病1 075例、咯血936例、耐药389例和药物反应1 074例;青少年组并发症例数(3 380例)低于中老年组(3 547例))P<0.05);肺外结核患者占肺结核患者(PTB)比例为36.24%,糖尿病占11.28%,药物不良反应占11.27%,咯血占9.82%和耐药占4.08%;并发症的患病比例总体呈上升趋势(χ~2=23.503,P<0.01)。结论:苏州地区肺结核患者主要合并症为肺外结核、糖尿病;患者年龄小于40岁的人群合并肺外结核概率为最高,大于60岁易出现耐药、药物反应,应规范肺结核患者合并症的诊疗,以提高对复杂肺结核病的诊断治疗水平。Objective: To analyze the causes and distribution tendency of pulmonary tuberculosis(PTB) complications in Suzhou area, and to provide a reference for improving the diagnosis and treatment of tuberculosis. Methods: The medical records of 9 528 cases of tuberculosis patients were collected from 2011 to 2017, and 6 927 cases of complications were recorded. Patients with extrapulmonary tuberculosis and hemoptysis were included in the adolescent group(n=4 389), and the patients with diabetes, drug resistance and drug response were included in the elderly group(n=2 538). The spectrum, time and age distribution of PTB complications were analyzed. Results: 6 927 hospitalized patients with PTB complications accounted for 72.70% of PTB patients. There were tuberculosis complications such as 3 453 acses of extrapulmonary tuberculosis, 1 075 cases of diabetes, 936 cases of hemoptysis, 389 cases of drug resistance and 1074 cases of drug reactions. The number of complications in the adolescent group(3 380 cases) was lower than that in the elderly group(3 547 cases)(P<0.05). Extrapulmonary tuberculosis patients(PTB) accounted for 36.24%, diabetes11.28%, adverse drug reactions 11.27%, hemoptysis 9.82% and drug resistance 4.08%. The incidence of complications is on the rise(χ~2=23.503, P<0.01). Conclusion: The main complications of PTB in Suzhou area are extrapulmonary tuberculosis and diabetes mellitus. The patients under 40 years old had the highest probability of extrapulmonary tuberculosis;the drug resistance was easy to occur in patients over 60 years old, so the diagnosis and treatment of complicated PTB should be standardized in order to improve the level of diagnosis and treatment of complicated PTB.

关 键 词：肺结核 合并症 肺外结核 糖尿病 咯血 耐药 药物反应 

分 类 号：R969.3[医药卫生—药理学]