美沙酮替代治疗者合并肺结核62例临床分析

目的探讨美沙酮替代治疗(吸毒致海洛因依赖者)者合并肺结核的临床特点及诊疗效果,以提高对该人群结核病的诊断水平。方法回顾性分析2005年1月至2010年12月高州市慢性病防治站收治的62例美沙酮替代治疗者合并肺结核的临床资料,比较观察组(吸毒组)62例和对照组(非吸毒组)72例肺结核患者的临床症状、结核分布类型、痰Mtb检测情况及X线胸片或胸部CT的检查。结果观察组中患者病灶范围累及2个以上肺野占有率82.3%(51/62)]、空洞形成率77.4%(48/62)、痰菌阳性率71.0%(44/62);对照组病灶范围累及2个以上肺野占有率54.2%(39/72)]、空洞形成率51.4%(37/72)、痰菌阳性率44.4%(32/72),两组比较差异具有统计学意义(χ2值分别为11.92、9.73、9.54,P值均<0.01)。结论美沙酮替代治疗者合并肺结核病情重,合并症多,X线胸片病变范围广、复发率及耐药率高。全社会应高度重视对吸毒肺结核患者的防治工作。

A clinical analysis of 62 cases of methadone replacement therapy associated with tuberculosis

Objective We explored the clinic characteristics and efficacy in cases of methadone replacement therapy(heroin dependent patients) associated with tuberculosis in order to improve the diagnostic level on such disease.Methods We analyzed retrospectively our hospital’s clinic data of 62 cases of heroin dependent patients with tuberculosis(observation group) between January 2005 and December 2010,compared with the control group(72 cases with no drug use) in clinic symptoms,lesion distribution,sputum detection,and imagings of X ray or CT.Results In the observation group,the rate of over 2 lung fields was 82.3%(51/62),77.4%(48/62)patients had cavites and 71.0%(44/62)were sputum positive.In the control group,the rate of over 2 lung field was 54.2%(39/72),51.4%(37/72)had cavities and 44.4%(32/72)were sputum postive.There were statistically significant differences between two groups(χ2=11.92,9.73,9.54,P values were all less than 0.01).Conclusion Patients of methadone replacement therapy with tuberculosis are obviously more serious.The society should pay high attention to the prevention and treatment for these patients.