气管支气管结核合并肺空洞的临床特征及危险因素研究  

Study of clinical features and risk factors of tracheobronchial tuberculosis combined with pulmonary cavitation

作　　者：丰银平 郭净 张尊敬[1] 刘忠达 FENG Yinping;GUO Jing;ZHANG Zunjing;LIU Zhongda(Department of Tuberculosis,Lishui Hospital of Traditional Chinese Medicine,Affiliated to Zhejiang University of Traditional Chinese Medicine,Lishui 323000,Zhejiang,China)

机构地区：[1]浙江中医药大学附属丽水中医院结核病科,浙江丽水323000

出　　处：《中国现代医生》2023年第8期5-9,共5页China Modern Doctor

基　　金：浙江省中医药科技计划项目(2022ZB399);丽水市科技计划项目(2020GYX27);丽水市绿谷医坛新秀人才项目。

摘　　要：目的分析气管支气管结核(tracheobronchial tuberculosis,TBTB)合并肺空洞的临床特征及危险因素,为更有效防治TBTB提供依据。方法回顾性分析2020年1月至2022年1月丽水市中医院收治的65例TBTB患者的临床资料,根据影像学是否合并空洞,分为空洞组(n=28)与无空洞组(n=37),统计分析合并空洞患者的临床特征,采用多因素Logistic回归分析TBTB合并肺空洞的危险因素。结果合并肺空洞患者病灶部位最常累及的是双侧多叶,痰液标本涂片、Xpert涂片、结核培养及肺泡灌洗液(bronchoalveolar lavage fluid,BALF)涂片阳性率均显著高于无空洞组(P<0.05)。多因素Logistic回归分析显示糖尿病[比值比(odds ratio,OR)=7.266,95%置信区间(confidence interval,CI):1.492~35.373)]、病程≥1个月(OR=8.069,95%CI:1.311~49.655)、低蛋白血症(OR=5.220,95%CI:1.155~23.597)、溃疡坏死型(OR=6.626,95%CI:1.088~40.350)是TBTB伴空洞的危险因素(P<0.05)。结论TBTB合并肺空洞患者病灶部位最常累及的是双侧多叶,合并糖尿病、病程≥1个月、低蛋白血症、溃疡坏死型TBTB患者更容易合并肺空洞,应及早进行临床干预。Objective To analyze the clinical features and risk factors of tracheobronchial tuberculosis(TBTB)combined with pulmonary cavitation,and to provide a basis for more effective prevention and treatment of TBTB.Methods The data of TBTB patients admitted to Lishui Hospital of Traditional Chinese Medicine from January 2020 to January 2022 were retrospectively analyzed,and they were divided into cavitary group(n=28)and non-cavitary group(n=37)by radiographic findings.Multivariate Logistic regression was used to analyze the risk factors of TBTB combined with lung cavities.Results In patients with combined pulmonary cavitation,the most frequently involved lesions were bilateral multilobar,and the positive rates of sputum specimen smear,Xpert smear,TB culture and bronchoalveolar lavage fluid(BALF)smear were significantly higher than those in the group without cavitation(P<0.05).Multifactorial logistic regression analysis showed that diabetes mellitus[odds ratio(OR)=7.266,95%confidence interval(CI):1.492-35.373],disease duration≥1 month(OR=8.069,95%CI:1.311-49.655),hypoprotein blood(OR=5.220,95%CI:1.155-23.597),and ulcerated necrotic type(OR=6.626,95%CI:1.088-40.350)were risk factors for TBTB with cavitation(P<0.05).Conclusion Patients with TBTB combined with pulmonary cavitation are most often involved in bilateral multilobar lesions.Patients with combined diabetes,disease duration≥1 month,hypoproteinemia,and ulcerated necrotic TBTB are more likely to have combined pulmonary cavitation and should undergo early clinical intervention.

关 键 词：气管支气管结核 肺结核 空洞 溃疡坏死型 危险因素 

分 类 号：R52[医药卫生—内科学] R562[医药卫生—临床医学]