肝硬化合并结核病患者的临床特征  

Clinical characteristics of patients with liver cirrhosis and tuberculosis

作　　者：毛娟娟[1,2] 金茜 叶丹[1] 杨亦德[1] 侯巍 程伟松[1] 盛吉芳[2] MAO Juan-juan;JIN Qian;YE Dan;YANG Yi-de;HOU Wei;CHENG Wei-song;SHENG Ji-fang(Department of Infectious Disease,Taizhou Municipal Hospital,Taizhou,Zhejiang 318000,China;不详)

机构地区：[1]台州市立医院感染科,浙江318000 [2]浙江大学医学院附属第一医院感染科

出　　处：《中国微生态学杂志》2021年第5期553-555,559,共4页Chinese Journal of Microecology

基　　金：浙江省医药卫生科技计划(2019KY787);浙江省医药卫生科技计划(2018KY904);台州市医学会科学研究基金(TZSYXH15-35)。

摘　　要：目的分析肝硬化合并结核病患者的临床特征,为该类患者的治疗提供参考。方法回顾性分析2014年9月至2017年7月于浙江大学医学院附属第一医院住院的肝硬化合并结核病患者的相关资料,总结患者的临床特征。结果共收治68例肝硬化合并结核病患者,其中男性50例(73.5%),女性18例(26.5%),平均年龄(59.9±13.7)岁。在所有患者中,肝硬化最常见的原因是HBV感染(46例,67.7%)和酒精(9例,13.2%)。肺结核(43例)、结核性腹膜炎(13例)、结核性胸膜炎(12例)是最常见的结核类型,此外骨关节结核、结核性脑膜炎、结核性心包炎、泌尿系结核、肠结核、淋巴结结核均可见。该类患者常见临床表现为乏力、腹胀,出现发热的患者不足半数,有盗汗表现的更为罕见。结论肝硬化患者并发结核后可使病情复杂化,增加治疗难度。此外部分患者临床表现不典型,需提高警惕,避免漏诊。Objective To explore the clinical characteristics of patients with cirrhosis and tuberculosis and provide a reference for treatment. Methods The data of patients with cirrhosis and tuberculosis who admitted to the First Affiliated Hospital of Zhejiang University School of Medicine from September 2014 to July 2017 were retrospectively analyzed, and the clinical characteristics of these patients were summarized. Results A total of 68 patients with liver cirrhosis and tuberculosis were enrolled, including 50 males(73.5%) and 18 females(26.5%). The average age was(59.9 ± 13.7) years. In these patients, the most common reasons of cirrhosis were HBV infection(46 cases, 67.7%) and alcohol(9 cases, 13.2%). Tuberculosis(43 cases), tuberculous peritonitis(13 cases) and tuberculous pleurisy(12 cases) were the most common types of tuberculosis infection. In addition, there were rare cases of bone and joint tuberculosis, tuberculous meningitis, tuberculous pericarditis, urinary tuberculosis, intestinal tuberculosis, and lymph node tuberculosis. The clinical manifestations of patients in this cohort were fatigue and abdominal distension;less than half of the patients had fever, fewer had night sweats. Conclusion Liver cirrhosis concomitant with tuberculosis complicates the condition and increases the difficulty of treatment. In addition, the clinical manifestations of some patients are not typical, and vigilance is required to avoid missed diagnosis.

关 键 词：肝硬化 结核病 感染 

分 类 号：R378[医药卫生—病原生物学]