633例肺结核患者不同发现方式的特征对比  

A comparative study on the characteristics of 633 patients with pulmonary tuberculosis found by different ways in discovery

作　　者：龚芳[1] 谭守勇[2] 刘国标[1] 唐惠红[1] GONG Fang;TAN Shou-yong;LIU Guo-biao;TANG Hui-hong(First Outpatient Service,The Guangzhou Chest Hospital,The Guangzhou Tuberculosis Control Institute,Guangzhou,Guangdong 510095;State Key Laboratory of Respiratory Diseases,Guangzhou Chest Hospital,Guangzhou,Guangdong 510095,China)

机构地区：[1]广州市胸科医院第一门诊部,广州市结核病防治一分所,广东广州510095 [2]广州市胸科医院,国家呼吸疾病重点实验室,广东广州510095

出　　处：《热带医学杂志》2022年第2期243-245,264,共4页Journal of Tropical Medicine

基　　金：广州市科技计划项目(155700012);广州市高水平临床重点专科和培育专科建设项目(穗卫函[2019]1555号)。

摘　　要：目的探讨社区采用不同方式发现肺结核患者的临床特征。方法对2019年1月1日-2019年12月31日在广州市越秀区登记肺结核患者临床特征进行分析。根据就诊方式分为主动发现组和被动发现组。结果主动发现组301例(47.55%),被动发现组332例(52.45%)。主动发现组患者年龄22.5~53.0岁,中位数34.0岁;被动发现组患者年龄28.0~57.0岁,中位数44.0岁,主动发现组患者平均年龄低于被动发现组年龄,差异有统计学意义(U=39754,P=0.000)。病原学痰涂片抗酸杆菌阳性率方面,主动发现组患者(19.46%)低于被动发现组(43.60%),差异有统计学意义(χ^(2)=41.721,P=0.000)。影像学上,肺部病灶范围≥3个肺野,主动发现组98例(32.56%)低于被动发现组168例(50.61%),两组患者病灶范围差异有统计学意义(χ^(2)=22.467,P=0.000)。主动发现组肺部有空洞者(21.60%)低于被动发现组(34.04%),差异有统计学意义(χ^(2)=12.090,P=0.001);在既往治疗史上,肺结核复治主动发现组7例(2.33%)低于被动发现组25例(7.53%),两组患者肺结核患者登记差异有统计学意义(χ^(2)==8.909,P=0.003)。结论主动发现肺结核患者痰涂片阳性率低,病灶范围较小,病情较轻。采用主动发现方式,可对肺结核患者早期诊断和早期治疗,有助于提高肺结核的治愈率。Objective To discuss different ways in discovering tuberculosis patients in the community.Methods The clinical features of tuberculosis patients registered in Yuexiu district,Guangzhou from January 1 st,2019 to December 31 st,2019 were analyzed.The patients were divided into active discovery group and passive discovery group according to the treatment method.Results There were 301 cases(47.55%)in active discovery group and 332 cases(52.45%)in passive discovery group.Patients’ age range in the active discovery group was 22.5-53.0 years old,and median was 34.0;while the age range of patients in the passive discovery group was 28.0-57.0 years old,and median was 44.0.The average age of patients in the active discovery group was lower than that in the passive discovery group,and the difference was statistically significant(U=39 754,P=0.000).In terms of the positive rate of acid-fast bacilli in pathogenic sputum smear,the active discovery group(19.46%)was significantly lower than the passive discovery group(43.60%)(χ^(2)=41.721,P=0.000).The range of lung lesions ≥3 lung fields in the active discovery group(98 cases,32.56%)was significantly lower than that in the passive discovery group(168 cases,50.61%)(χ^(2)=22.467,P=0.000).The active discovery group(21.60%)has fewer lung cavities than the passive discovery group(34.04%),and the difference was statistically significant(χ^(2)=12.090,P=0.001).In terms treatment history of tuberculosis,7 cases(2.33%)in the active discovery group was lower than 25 cases(7.53%)in the passive discovery group,and there was a statistical significance in the registration difference of tuberculosis patients between the two groups(χ^(2)=8.909,P=0.003).Conclusions Active discovery of tuberculosis patients had low positive sputum smears,small lesion range and mild.Active discovery should be used because it could diagnose and treat the tuberculosis patient at the early stage,and was helpful to improve the cure rate of tuberculosis.

关 键 词：肺结核 主动发现 被动发现 

分 类 号：R521[医药卫生—内科学]