精神障碍伴发肺结核病118例临床分析

目的探讨精神障碍患者伴发肺结核病的临床特征。方法分析118例精神障碍患者伴发肺结核病的临床资料。结果 (1)社会人口学资料:男性111例(占94.1%)。(2)精神科资料:精神分裂症97例(占82.2%),精神分裂症病程≥20年者103例(占87.3%)。(3)结核病资料:病灶范围≥3个肺野103例(占87.3%);痰抗酸杆菌涂片阳性39例(阳性率33.1%,39/118),痰分枝杆菌培养阳性者34例(阳性率28.8%);24例患者的药敏试验结果提示耐药(耐药率20.3%,24/118)。(4)其它资料:躯体合并症以糖尿病为主,19例(发生率16.1%);死亡18例(死亡率15.3%)。结论精神分裂症是最常见的伴发肺结核病的精神障碍,精神障碍伴发肺结核病具有病灶范围大、耐药率高、躯体合并症多、死亡率高等特征。

Clinical analysis on 118 tuberculosis patients with mental illness

Objective To explore the clinical features of mental disorder patients with tuberculosis. Methods A retrospective study was performed on 118 patients who suffered from mental illness with tuberculosis. Results There were 111 male cases （94. 1% ）. 97 cases （82. 2% ） were schizophrenia patients, and 103 cases （87.3%） had more than 20 years course of schizophrenia. There were 103 cases whose focal range more than three lung field （87.3%）, 39 cases with positive sputum smear of acid fast bacilli （33.1% ） , and 34 cases of positive sputum my- cobacterium cultivation （28. 8% ）. 24 patients showed certain drug resistance by drug susceptibility test （20. 3% ）. Diabetes was one of the most common complications （ 19 cases）, and 18 cases of death reported （ 15.3% ）. Conclusion In these cases, schizophrenia is one of the most common mental disorders. Mental disorders with tuberculosis have some characteristics： large focal range, high resistance, more complications and high mortality. TB community and psychiatric community should pay high attention to these patients.