220例老年肺结核临床分析

目的：了解老年肺结核的临床特征。方法：对本所2009年1月-2012年12月收治的单纯活动性肺结核患者（无结核性胸膜炎等其他结核病）进行回顾性分析。结果：临床症状以咳嗽、咳痰多见,占78.6%（173/220）;70~79岁101例,略高于60~69岁81例;病灶广泛,分布1~2个肺野占60.9%（134/220）,3个及以上肺野86例,占39.1%（86/220）;痰菌阳性率高31.4%（69/220）,合并症多;痰菌转阴率79.7%（55/69）,总有效率89.5%（191/220）;药物不良反应多,以肝损害为主,占9.5%（21/220）,其次为白细胞减少症3.2%（7/220）、皮肤过敏反应1.8%（4/220）。结论：220例老年肺结核患者症状以咳嗽、咳痰为主,结核中毒症状不典型;病灶以多肺区为主;合并其他疾病几率高,以肺部感染为首;老年肺结核的治疗应个体化。

Clinical Analysis of 220 Cases of Senile Pulmonary Tuberculosis

Objective： To investigate the clinical characteristics of senile pulmonary tubercasis.Method： In 2009 January-2012 December were simple in patients with active pulmonary tuberculosis （ no tuberculous pleurisy and other tuberculosis）, retrospective analysis. Result： Clinical symptoms were cough, sputum accounted for 78.6% （ 173/220 ） .People from 70 to 79 years old were 101 cases which is slightly higher than the 60 to 69 years old in 81 cases.Wide distribution of lesions, 1-2 lung accounted for 60.9% （ 134/220 ）, More than 3 and lung field in 86 cases, accounting for 39.1% （ 86/220 ） . High positive rate of sputum was 31.4% （ 69/220 ） .Most of them were multiple complications.The sputum negative conversion rate was 79.7% （ 55/69 ）, with the total efficiency of 89.5% （ 191/220 ） ; Adverse drug reactions which mainly with liver damage were accounted for 9.5% （ 21/220 ） .Followed by leukopenia in 3.2% （ 7/220 ） and allergic skin reaction was 1.8% （ 4/220 ） .Conclusion： 220 cases of pulmonary tuberculosis patients with symptoms of cough, expectoration, clinical symptoms are not typical; lesions in lung zone; associated with other diseases with high probability, led by pulmonary infection; treatment of senile pulmonary tuberculosis should be individualized.