合并肺结核的新型冠状病毒肺炎患者的临床特征及转归分析  

Clinical characteristics and outcome analysis of COVID-19 patients with pulmonary tuberculosis

作　　者：滕佩坤 韩秀迪[1] 刘彧展 赵伟业[1] 刘德顺 刘学东[1] Teng Pei kun;Han Xiudi;Liu Yuzhan;Zhao Weiye;Liu Deshun;Liu Xuedong(Department of Respiratory and Critical Care Medicine,Qingdao Municipal Hospital,Qingdao 266011,China)

机构地区：[1]青岛市市立医院呼吸与危重症医学科,青岛266011

出　　处：《中华结核和呼吸杂志》2022年第5期510-514,共5页Chinese Journal of Tuberculosis and Respiratory Diseases

摘　　要：新型冠状病毒(简称新冠病毒)肺炎(COVID-19)和结核病是两种主要经呼吸道飞沫传播力极强的呼吸道传染病,发病率高,均可导致患者免疫力下降,CD4^(+)T细胞降低。COVID-19可以在结核病诊断之前、同时或之后发生。而肺结核病患者有COVID-19流行病学接触史时,也更容易再合并感染,目前国内外已相继报道多起结核病院因院感防控措施不力引起COVID-19院感事件,故加强结核病院院感防控工作刻不容缓。二者叠加感染会导致预后恶化,加重患者病情,给治疗带来更大的困难。另外,在新冠疫情的背景下,当胸科医院的肺结核患者出现聚集性发热等症状或病情进展时,应尽早识别是否合并新冠病毒感染。同时注重识别结核病和COVID-19叠加的临床表现、影像学表现等。目前关于COVID-19合并肺结核的研究相对匮乏,且在多方面存在争议,我国作为结核病高发国,明确两种传染病的临床特点、转归、治疗等具有重大现实意义。Coronavirus disease(COVID-19)and tuberculosis(TB)are two respiratory infectious diseases with a high incidence of transmission,mainly via respiratory droplets and both can weaken the immune system and lower the number of CD4^(+)T cells in patients.COVID-19 can occur before,at the same time or after the diagnosis of TB.Patients with pulmonary TB are more likely to have co-infection when they have a history of epidemiological exposure to COVID-19.At present,many cases of nosocomial infection of COVID-19 caused by ineffective prevention and control measures in tuberculosis hospitals have been reported successively at domestic and overseas.Therefore,it is urgent to strengthen the prevention and control of nosocomial infections in tuberculosis hospitals.The superposition of the two diseases can lead to a worsening prognosis,aggravating the patient′s condition and making treatment more difficult.In addition,in the context of the new coronavirus epidemic,early recognition of co-infection with new coronavirus should be made when TB patients in chest hospitals present with symptoms such as aggregated fever or progressive disease.At the same time,we should focus on identifying the clinical and imaging manifestations of TB and COVID-19 co-infection.At present,research on COVID-19 complicated with pulmonary TB is scarce,and there are disputes on many aspects.As a country with a high prevalence of tuberculosis,it is of great practical significance to identify the clinical characteristics,outcomes,and treatment of the two infectious diseases in China.

关 键 词：肺结核病患者 胸科医院 肺炎患者 合并肺结核 肺结核患者 结核病诊断 呼吸道传染病 流行病学 

分 类 号：R521[医药卫生—内科学] R563.1[医药卫生—临床医学]