免疫抑制剂相关肺结核的临床特点及X线表现

目的 总结免疫抑制剂相关肺结核的临床特点及X线表现。资料与方法回顾性对照分析46例免疫抑制剂相关肺结核与51例普通肺结核的临床特点及X线表现。结果与普通肺结核相比，免疫抑制剂相关肺结核以中高热、乏力多见，干咳和胸痛少见；病情重，合并其他病原体感染、继发性肺结核、结核性胸膜炎及合并肺外结核多见；X线上多表现为均匀一致的片絮状阴影；合并肺门或纵隔淋巴结肿大少见；病灶分布范围较广，以非肺结核好发部位发病率高，多分布在双侧肺、中肺野及下肺野。结论免疫抑制剂相关肺结核的临床表现及X线特征与普通肺结核有所不同，易误诊，应引起临床高度重视。

Clinical Features and Radiological Maniflestations of Pulmonary Tuberculosis in Immunocompromised Patients

Objective To summarize the clinical and radiological characteristics of tuberculosis in immunocompromised patients.Materials and Methods The clinical features and radiological presentations of pulmonary tuberculosis between 46 immunocompromised and 51 non-immunocompromised patients were retrospectively analyzed and compared.Results Compared with common tuberculosis,the middle and high fever and hypodynamia were common in immunocompromised patients.The dry cough and chest pain occurred rarely.The patients' condition in the immunocompromised tuberculosis was more severe,and immunocompromised tuberculosis was easily complicated with the infection caused by other agents.The secondary pulmonary tuberculosis and tuberculous pleurisy,and the extrapulmonary tuberculosis appeared more frequently in the immunocompromised tuberculosis.The lesions were often homogeneous patchy shadow.The hilar or mediastinal lymphadenopathy was rarely occurred.The lesions involved more zones,and located more in the non-common site,mostly in the middle and lower zones of the bilateral lungs.Conclusion The clinical presentations and radiological features in the immunocompromised tuberculosis are different from those of the common tuberculosis and often led to misdiagnosis.