老年慢性阻塞性肺疾病合并肺结核的临床分析

目的对老年慢性阻塞性肺疾病（COPD）合并肺结核（PTB）的临床特点进行回顾性分析。方法 2006年7月-2012年7月本院呼吸内科收治的老年COPD并发肺结核患者48例,其中活动性PTB（A组）23例,陈旧性PTB（B组）25例,另选择同期住院COPD患者无结核（C组）26例。分析比较上述各组患者各临床相关指标以及住院时间、住院费用等。结果与C组相比,B组感染指标血沉（ESR）、C反应蛋白（CRP）较高,营养学指标血红蛋白（Hb）、白蛋白（ALB）和体重指数（BMI）较低,差异有统计学意义（P〈0.05）;而B组感染指标ESR、CRP高于A组,营养学指标Hb、ALB低于A组,差异有统计学意义（P〈0.05）;老年COPD合并PTB患者住院时间长、住院费用高。结论肺结核影响老年慢性阻塞性肺疾病的临床进程,主要表现为COPD合并PTB病情重以及营养状态较差、住院时间较长及住院费用高。

Clinical Analysis on Elderly Patients with Chronic Obstructive Pulmonary Disease and Pulmonary Tuberculosis

Objective To take the retrospective analysis on clinical characteristics of the elderly patients with chronic obstructive pulmonary disease（COPD） and pulmonary tuberculosis（PTB）.Methods Chose 48 elderly patients with COPD and pulmonary tuberculosis in this hospital from July 2006 to July 2012,including 23 cases with active PTB（group A） and 25 cases with obsolete PTB（group B）,and chose another 26 cases with COPD but without PTB during the same period（group C）.Analyzed and compared all related clinical indexes,hospitalization time and fees of patients in each group.Results Compared to group C,it was higher in infection indexes of erythrocyte sedimentation rate（ESR） and C-reactive protein,and lower in nutrition indexes of hemoglobin（Hb）,albumin（Alb） and body mass index（BMI） in group B,with the statistical significance（P 0.05）;while compared to group A,it was higher in infection indexes of ESR and CRP,and lower in nutrition indexes of Hb and Alb in group B,with the statistical significance（P 0.05）;the elderly patients with COPD and PTB were characterized by the long hospitalization time and high hospitalization fees.Conclusion The pulmonary tuberculosis affects the clinical progression of the elderly chronic obstructive pulmonary disease,with the characteristics of severe disease of COPD and PTB,poor nutrition condition,long hospitalization time and high hospitalization fees.