结核病专科医院活动性结核病死亡患者及其不同年龄组临床特征分析  

Clinical characteristics of patients died of active tuberculosis with different ages in tuberculosis specialized hospital

作　　者：刘伟坚 徐宇翔 詹森林[1] 张培泽[1] 覃红娟 Liu Weijian;Xu Yuxiang;Zhan Shenlin;Zhang Peize;Qin Hongjuan(Department of Pulmonary Diseases,National Clinical Research Center for Infectious Disease/The Second Affiliated College of Southern University of Science and Technology/Shenzhen Clinical Research Center for Tuberculosis/Third People’s Hosptial of Shenzhen,Shenzhen 518112,China)

机构地区：[1]深圳市第三人民医院国家感染性疾病临床医学研究中心/南方科技大学第二附属医院/深圳市结核病临床医学研究中心/深圳市第三人民医院肺病医学部,深圳518112

出　　处：《结核与肺部疾病杂志》2024年第5期445-452,共8页Journal of Tuberculosis and Lung Disease

基　　金：深圳市结核病临床医学研究中心(20210617141509001)。

摘　　要：目的:分析活动性结核病死亡患者及其不同年龄组临床特征,为降低结核病患者病亡率提供参考依据。方法:采用回顾性研究方法,参照入组标准收集2013年1月1日至2022年12月31日深圳市第三人民医院收治的469例因活动性结核病死亡成年患者的人口学情况(年龄、性别)和临床资料(住院次数、住院天数、结核感染部位、是否复治、药物敏感性试验结果、是否需机械通气治疗、合并症和并发症等),根据年龄分布将患者分为青年组(44岁以下)、中年组(44~59岁)和老年组(≥60岁),比较死亡患者及其不同年龄组的临床特征。结果:469例结核病死亡患者中,年龄中位数(四分位数)为56(40,73)岁,男性[389例(82.94%)]明显多于女性[80例(17.06%)],住院天数为8.0(3.0,22.0)d;老年组最多[208例(44.35%)],青年组次之[150例(31.98%)],中年组最少[111例(23.67%)];仅有肺结核者最多[351例(74.84%)],其次为并发多系统结核者[102例(21.75%)];合并营养不良[185例(39.45%)]、心血管疾病[159例(33.90%)]、糖尿病[102例(21.75%)]、中枢神经系统疾病[85例(18.12%)]、HIV感染[69例(14.71%)],以及需要机械通气者[100例(21.32%)]较多,而发生耐药[17例(3.62%)]和复治[44例(9.38%)],以及并发粟粒性肺结核及结核性脑膜脑炎者[21例(4.48%)]并不多。其中,青年、中青年和老年组患者中,男性[125例(83.33%)、100例(90.09%)和164例(78.85%)]、仅发生肺结核[93例(62.00%)、83例(74.77%)和175例(84.13%)]和多系统结核[50例(33.33%)、21例(18.92%)和31例(14.90%)],以及合并营养不良[79例(52.67%)、44例(39.64%)和62例(29.81%)]、HIV感染[44例(29.33%)、20例(18.02%)和5例(2.40%)]、糖尿病[11例(7.33%)、29例(26.13%)和62例(29.81%)]、心血管疾病[14例(9.33%)、25例(22.52%)和120例(57.69%)]、慢性肺疾病[0例(0.00%)、7例(6.31%)和39例(19.02%)]、肝衰竭[11例(7.33%)、19例(17.12%)和15例(7.21%)]、慢性肾脏病5期[4例(2.67%)、9例(8.11%)和31例(14.90%)]�Objective:To analyze the clinical characteristics of patients who died of active tuberculosis,to provide a reference basis for reducing case fatality rate of tuberculosis patients.Methods:Demographic information(age,sex)and clinical data(number and days of hospitalizations,tuberculosis infection site,primary or retreatment,drug susceptibility test result,mechanical ventilation or not,comorbidities and complications)of patients who died of active tuberculosis at Shenzhen Third People’s Hospital from 1 January 2013 to 31 December 2022 were retrospectively collected.The patients were divided into young(<44 years),middle-aged(44-59 years),and elderly(≥60 years)groups,and their clinical characteristics were compared.Results:A total of 469 patients died of active tuberculosis,their median(quartile)age was 56(40,73)years,there were significantly more males(389 cases(82.94%))than females(80 cases(17.06%)).Median days of hospitalization was 8.0(3.0,22.0)d.The elderly group was the largest group(208 cases(44.35%)),followed by the young group(150 cases(31.98%)),and the least cases were in the middle-aged group(111 cases(23.67%));Highest number of cases only got pulmonary tuberculosis(351 cases(74.84%)),followed by those with concurrent multi-system tuberculosis(102 cases(21.75%));Patients with malnutrition(185 cases(39.45%)),cardiovascular disease(159 cases(33.90%)),diabetes mellitus(102 cases(21.75%)),and central nervous system disease(85 cases(18.12%)),HIV infection(69 cases(14.71%)),and those who required mechanical ventilation(100 cases(21.32%))were very common,whereas the occurrence of drug resistance(17 cases(3.62%))and retreatment(44 cases(9.38%)),as well as getting both pulmonary tuberculosis and tuberculous meningoencephalitis(21 cases(4.48%))were not much.Among patients in young,middle-aged and elderly groups,proportions of being male(125(83.33%),100(90.09%)and 164(78.85%)),getting pulmonary tuberculosis only(93(62.00%),83(74.77%)and 175(84.13%))or having multi-system tuberculosis(50(33.33%),21(18.92%)and 31(1

关 键 词：结核 死亡 年龄分布 疾病特征 

分 类 号：R52[医药卫生—内科学] R211[医药卫生—临床医学]