老年肺结核的临床特征及其防治相关知识的影响因素  

Clinical characteristics of pulmonary tuberculosis and factors influencing knowledge awareness of its prevention and treatment in the elderly

作　　者：汤咏军[1] 鲍美娟[1] Tang Yongjun;Bao Meijuan(Department of Infection Control,Shanghai Public Health Clinical Center,Shanghai 201508,China)

机构地区：[1]上海市公共卫生临床中心,上海201508

出　　处：《中华老年多器官疾病杂志》2025年第3期187-191,共5页Chinese Journal of Multiple Organ Diseases in the Elderly

基　　金：上海市公共卫生临床中心科研启动基金(KY-GW-2017-29)。

摘　　要：目的分析老年肺结核的临床特征及其防治相关知识的影响因素。方法将2017年7月至2019年10月上海市公共卫生临床中心收治的年龄≥60岁的165例老年肺结核患者作为研究对象(老年组),另选择同期收治的165例中青年肺结核患者作为对照(中青年组),收集两组患者临床资料,分析比较其临床特征,包括临床表现、实验室检查及肺部CT检查情况。并对老年肺结核患者进行肺结核防治知识问卷调查,根据防治知识问卷结果将患者分为全知晓组与非全知晓组,采用单因素分析和多因素logistic回归分析影响老年肺结核患者防治知识的因素。采用SPSS 26.0统计软件进行数据分析。组间比较采用χ2检验。结果老年肺结核患者临床表现主要为咳嗽(58.18%)、胸闷(57.58%)、胸痛(55.76%),2个及以上临床表现者73例(44.24%),3个及以上症状表现者92例(55.76%);实验室检查显示结核菌素纯蛋白衍生物(PPD)试验阳性率69.70%,抗酸杆菌涂片阳性率40.00%,肺部CT表现主要为结节阴影(89.09%)、钙化(54.55%)、渗出毛玻璃影(45.45%)、胸腔积液(41.82%)。老年肺结核患者胸痛比率高于中青年肺结核患者,发热、盗汗比率低于中青年肺结核患者,结节阴影、心包积液、钙化比率高于中青年肺结核患者(均P<0.05)。防治知识问卷调查结果显示,老年肺结核患者对所有问题的全知晓率为36.97%,对肺结核主要传播途径知晓率最高,为66.06%;对肺结核药物不良反应处理知晓率最低,为44.85%。单因素分析显示,全知晓组年龄、文化程度、家庭有人患过结核病与非全知晓组比较差异均有统计学意义(P<0.05)。多因素logistic回归分析显示,文化程度为小学及文盲、家庭有人患过结核病是老年肺结核患者防治知识的影响因素(OR=2.849、2.735;P<0.05)。结论老年肺结核患者更容易出现胸痛症状,影像学检查中结节阴影、心包积液、钙化发生率也相对较高;�Objective To analyze the clinical characteristics of pulmonary tuberculosis(PTB)and the factors influencing know-ledge awareness of its prevention and control in the elderly.Methods A total of 165 elderly PTB patients(aged≥60 years)admitted to the Shanghai Public Health Clinical Center from July 2017 to October 2019 were selected as the study group(elderly group),and another 165 middle-aged and young PTB patients admitted during the same period were chosen as the control group(young and middle-aged group).Clinical data of the two groups of patients were collected for analysis and their clinical characteristics were compared,including clinical manifestations,laboratory tests,and chest CT findings.In addition,a questionnaire survey on the knowledge of tuberculosis prevention and treatment was conducted among the elderly patients with pulmonary tuberculosis,and based on the questionnaire results,patients were divided into the fully informed group and the non-fully informed group.Univariate and multivariate logistic regression analyses were performed to identify factors influencing the knowledge awareness of prevention and treatment of pulmonary tuberculosis among the elderly patients.SPSS statistics 26.0 was used for statistical analysis.Data comparison between two groups was performed using χ^(2) test.Results Clinical manifestations of the elderly patients with pulmonary tuberculosis mainly included cough(58.18%),chest tightness(57.58%),and chest pain(55.76%).There were 73 cases(44.24%)with two or more clinical manifestations,and 92 cases(55.76%)with three or more symptoms.Laboratory tests showed a positive rate of 69.70%for tuberculin purified protein derivative(PPD)test and 40.00% for acid-fast bacilli smear,and common chest CT findings included nodular shadows(89.09%),calcification(54.55%),ground-glass opacities(45.45%),and pleural effusion(41.82%).The ratio of chest pain in the elderly patients with pulmonary tuberculosis was higher than that in the young and middle-aged patients,the ratios of fever and nigh

关 键 词：老年人 肺结核 临床特征 防治知识 影响因素 

分 类 号：R521[医药卫生—内科学]